Medicine and Health Sciences Commons^™

Relation Of Depression Symptoms To Sustained Reward And Loss Sensitivity, Michael P. Berry, Ema Tanovic, Jutta Joormann, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

Behavioral Disorders: A Nutritional Checklist For The Educational Practitioner, Ronald F. Bobner, Louisa M. Marchionda, Carolyn Ridenour, Isadore Newman, Mary J. Beaubien

Carolyn S. Ridenour

Millions of dollars are spent annually on special educational programs for children whose severe behavior disorders prevent them from participating in the regular school setting despite average or above average intellectual capacity. A growing body of research indicates that some of these behavior disorders are related to nutritional problems. (Pfeiffer and Iliev 1972; Kittler 1973; Mayron 1979; and Buckley 1977), and many clinicians support the view that no matter what the etiology of behavioral disorders, nutritional programs can improve the baseline data on medical, social and intellectual achievement, and on personality measures (Palmer 1978). Our purpose here is to present …

Personality And Life Events In A Personality Disorder Sample, Linden R. Timoney, Zach Walsh, M. Tracie Shea, Shirley Yen, Emily B. Ansell, Carlos M. Grilo, Thomas H. Mcglashan, Robert L. Stout, Andrew E. Skodol, Donna S. Bender, Charles A. Sanislow, Leslie C. Morey, John G. Gunderson

Charles A. Sanislow, Ph.D.

Prediction Of Dengue Disease Severity Among Pediatric Thai Patients Using Early Clinical Laboratory Indicators, James A. Potts, Robert V. Gibbons, Alan L. Rothman, Anon Srikiatkhachorn, Stephen J. Thomas, Pra-On Supradish, Stephenie C. Lemon, Daniel H. Libraty, Sharone Green, Siripen Kalayanarooj

Alan Rothman

BACKGROUND: Dengue virus is endemic in tropical and sub-tropical resource-poor countries. Dengue illness can range from a nonspecific febrile illness to a severe disease, Dengue Shock Syndrome (DSS), in which patients develop circulatory failure. Earlier diagnosis of severe dengue illnesses would have a substantial impact on the allocation of health resources in endemic countries. METHODS AND FINDINGS: We compared clinical laboratory findings collected within 72 hours of fever onset from a prospective cohort children presenting to one of two hospitals (one urban and one rural) in Thailand. Classification and regression tree analysis was used to develop diagnostic algorithms using different …

Prediction Of Dengue Disease Severity Among Pediatric Thai Patients Using Early Clinical Laboratory Indicators, James A. Potts, Robert V. Gibbons, Alan L. Rothman, Anon Srikiatkhachorn, Stephen J. Thomas, Pra-On Supradish, Stephenie C. Lemon, Daniel H. Libraty, Sharone Green, Siripen Kalayanarooj

Sharone Green

BACKGROUND: Dengue virus is endemic in tropical and sub-tropical resource-poor countries. Dengue illness can range from a nonspecific febrile illness to a severe disease, Dengue Shock Syndrome (DSS), in which patients develop circulatory failure. Earlier diagnosis of severe dengue illnesses would have a substantial impact on the allocation of health resources in endemic countries. METHODS AND FINDINGS: We compared clinical laboratory findings collected within 72 hours of fever onset from a prospective cohort children presenting to one of two hospitals (one urban and one rural) in Thailand. Classification and regression tree analysis was used to develop diagnostic algorithms using different …

Socioeconomic-Status And Mental Health In A Personality Disorder Sample: The Importance Of Neighborhood Factors, Zach Walsh, M. Tracie Shea, Shirley Yen, Emily B. Ansell, Carlos M. Grilo, Thomas H. Mcglashan, Robert L. Stout, Donna S. Bender, Andrew E. Skodol, Charles A. Sanislow, Leslie C. Morey, John G. Gunderson

Charles A. Sanislow, Ph.D.

This cross-sectional study examined the associations between neighborhood-level socioeconomic-status (NSES), and psychosocial functioning and personality pathology among 335 adults drawn from the Collaborative Longitudinal Personality Disorders Study. Participants belonged to four personality disorder (PD) diagnostic groups: Avoidant, Borderline, Schizotypal, and Obsessive Compulsive. Global functioning, social adjustment, and PD symptoms were assessed following a minimum two-year period of residential stability. Residence in higher-risk neighborhoods was associated with more PD symptoms and lower levels of functioning and social adjustment. These relationships were consistent after controlling for individual-level socioeconomic-status and ethnicity; however, the positive association between neighborhood-level socio-economic risk and PD symptoms was …

The Impact Of Worksite Weight-Related Social Norms On Associated Behaviors, Stephenie C. Lemon, Qin Liu, Robert P. Magner, Kristin L. Schneider, Lori Pbert

Qin Liu

Objective: To assess the association between descriptive social norms for weight and weight-related behaviors and associated behaviors at the worksite. Design and Sample: Baseline data from site-randomized trial of a worksite ecological intervention for weight control; 12 public high schools in central Massachusetts; Sample of 844 employees enrolled (~ 2/3 of all employees). Conclusions: Associations of weight loss and eating social norms with behavior; Unique from social support; No association of physical activity social norms with physical activity; May be little opportunity for and therefore little exposure to physical activity during the workday; Results support the development of weight loss …

Individuals With Single Versus Multiple Suicide Attempts Over 10 Years Of Prospective Follow-Up, Christina L. Boisseaua, Shirley Yen, John C. Markowitz, Carlos M. Grilo, Charles A. Sanislow, M. Tracie Shea, Mary C. Zanarini, Andrew E. Skodol, John G. Gunderson, Leslie C. Morey, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Background: The study attempted to identify characteristics that differentiate multiple suicide attempters from single attempters in individuals with personality disorders (PDs) and/or major depression.

Method: Participants were 431 participants enrolled in the Collaborative Longitudinal Study of Personality Disorders from July 1996 to June 2008. Suicide attempts were assessed with the Longitudinal Interval Follow-up Evaluation at 6 and 12months, then yearly through 10years. Logistic regression was used to compare single attempters to multiple attempters on Axis I and II psychiatric disorders and personality trait variables.

Results: Twenty-one percent of participants attempted suicide during the 10years of observation, with 39 (9.0%) reporting …

The Evolution Of A Labyrinth Walking Program In Corrections, Donna M. Zucker Rn, Phd, Faan, Lorraine Villemaire Ma, Ssj, Catherine Rigali Lpn, Kathryn Callahan Ms, Rn

Donna M. Zucker

The development and expansion of labyrinth walking in corrections has signaled a milestone in the treatment of offenders, particularly those incarcerated for substance abuse-related offenses. In this article we describe the evolution of the labyrinth walking program from its inception highlighting: curriculum development and refinement, evidence-based and program evaluation findings. Methods used in working with key stakeholders are illustrated to both implement and evaluate labyrinth walking, and to identify future directions.

Prospective Investigation Of A Ptsd Personality Typology Among Individuals With Personality Disorders, Meghan E. Mcdevitt-Murphy, M. Tracie Shea, Shirley Yen, Carlos M. Grilo, Charles A. Sanislow, John C. Markowitz, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

This study investigated the replicability of a previously proposed personality typology of posttraumatic stress disorder (PTSD, and explored stability of cluster membership over a 6-month period. Participants with current PTSD (n = 156) were drawn from the Collaborative Longitudinal Personality Disorders Study (CLPS). The CLPS project tracked a large sample of individuals who met criteria for 1 of 4 target diagnoses (borderline, schizotypal, avoidant, and obsessive-compulsive) and a contrast group of individuals who met criteria for depression but no personality disorder. A cluster analysis using scales from the Schedule of Nonadaptive and Adaptive Personality yielded 3 clusters: “internalizing,” “externalizing,” and …

Help-Negation For Suicidal Thoughts In Sub-Clinical Samples Of Young People, Coralie Joy Wilson

Coralie J Wilson

Across the popular and academic literature, it is widely recognised that young people with persistent suicidal thoughts are at high risk for suicide completion. It is also accepted that seeking and receiving appropriate help offers protection against the development of acute forms of suicidality, along with suicide completion. Yet, as promising as appropriate help-seeking appears for suicide prevention, a growing number of studies suggest that suicidal ideation itself may impede the help-seeking process. There is evidence that acutely suicidal samples will negate or avoid available help, and there are indications that the help-negation process may occur in samples before levels …

Avoidant Personality Disorder, Traits, And Type, Charles A. Sanislow, Katelin Da Cruz, May O. Gianoli, Elizabeth M. Reagan

Charles A. Sanislow, Ph.D.

In this chapter, the evolution of the avoidant personality disorder (AVPD) diagnosis, its current status, and future possibilities are reviewed. AVPD is a chronic and enduring condition involving a poor sense of self and anxiety in social situations, and it is marked by fears of rejection and a distant interpersonal stance. AVPD may be conceptualized at the severe end of a continuum of social anxiety. In the extreme, traits, mechanisms, and symptoms become integral to chronic dysfunction in personality and interpersonal style. While AVPD is a valid diagnostic construct, the optimal organization of AVPD criteria for the diagnosis, and the …

Avoidant Personality Disorder, Charles A. Sanislow, Ellen E. Bartolini, Emma C. Zoloth

Charles A. Sanislow, Ph.D.

No abstract provided.

Long Term Predictive Validity Of Diagnostic Models For Personality Disorder: Integrating Trait And Disorder Concepts, Leslie C. Morey, Christopher J. Hopwood, John C. Markowitz, John G. Gunderson, Carlos M. Grilo, Thomas H. Mcglashan, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Background. Several conceptual models have been considered for the assessment of personality pathology in DSM-5. This study sought to extend our previous findings to compare the long-term predictive validity of three such models: the Five-Factor Model (FFM), the Schedule for Nonadaptive and Adaptive Personality (SNAP), and DSM-IV personality disorders (PDs).

Method. An inception cohort from the Collaborative Longitudinal Personality Disorder Study (CLPS) was followed for 10 years. Baseline data were used to predict long-term outcomes, including functioning, Axis I psychopathology, and medication use.

Results. Each model was significantly valid, predicting a host of important clinical outcomes. Lower-order elements of the …

Long-Term Outcomes In Borderline Psychopathology: Old Assumptions, Current Findings, And New Directions, Charles A. Sanislow, Katherine L. Marcus, Elizabeth M. Reagan

Charles A. Sanislow, Ph.D.

Borderline personality disorder (BPD) and historical variants of the diagnosis were long held to represent an intractable syndrome of psychopathology consisting of interpersonal, intrapsychic, and affective disturbances. For years, patients labeled “borderline” were regarded pejoratively due at least in part to the lack of effective treatments. Prospective data from recent naturalistic follow-along studies along with the development of treatments with empirically demonstrated efficacy have changed how BPD is viewed. It is now less common to hide the diagnosis from the patient, and BPD has become a useful label to guide the treatment process and help the patient make sense of …

Interpersonal Pathoplasticity In The Course Of Major Depression, Nicole M. Cain, Emily B. Ansell, Aidan G. C. Wright, Christopher J. Hopwood, Katherine M. Thomas, Anthony Pinto, John C. Markowitz, Charles A. Sanislow, Mary C. Zanarini, M. Tracie Shea, Leslie C. Morey, Thomas H. Mcglashan, Andrew E. Skodol, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

Objective: The identification of reliable predictors of course in major depressive disorder (MDD) has been difficult. Evidence suggests that the co-occurrence of personality pathology is associated with longer time to MDD remission. Interpersonal pathoplasticity, the mutually influencing nonetiological relationship between psychopathology and interpersonal traits, offers an avenue for examining specific personality vulnerabilities that may be associated with depressive course. Method: This study examined 312 participants with and without a cooccurring personality disorder diagnosis who met criteria for a current MDD episode at baseline and who were followed for 10 years in the Collaborative Longitudinal Personality Disorders Study. Results: Latent profile …

Pathological Personality Traits Among Patients With Absent, Current, And Remitted Substance Use Disorders, Christopher J. Hopwood, Leslie C. Morey, Andrew E. Skodol, Charles A. Sanislow, Carlos M. Grilo, Emily B. Ansell, Thomas H. Mcglashan, John C. Markowitz, Anthony Pinto, Shirley Yen, M. Tracie Shea, John G. Gunderson, Mary C. Zanarini, Robert L. Stout

Charles A. Sanislow, Ph.D.

Personality traits may provide underlying risk factors for and/or sequelae to substance use disorders (SUDs). In this study Schedule for Nonadaptive and Adaptive Personality (SNAP) traits were compared in a clinical sample (N=704, age 18–45) with current, past, or no historical alcohol or non-alcohol substance use disorders (AUD and NASUD) as assessed by DSM-IV semi-structured interview. Results corroborated previous research in showing associations of negative temperament and disinhibition to SUD, highlighting the importance of these traits for indicating substance use proclivity or the chronic effects of substance use. Certain traits (manipulativeness, self-harm, disinhibition, and impulsivity for AUD, and disinhibition and …

Self-Harm Subscale Of The Schedule Of Nonadaptive And Adaptive Personality (Snap): Predicting Suicide Attempts Over 8 Years Of Follow-Up, Shirley Yen, M. Tracie Shea, Zach Walsh, Maria O. Edelen, Christopher J. Hopwood, John C. Markowitz, Emily B. Ansell, Leslie C. Morey, Carlos M. Grilo, Charles A. Sanislow, Andrew E. Skodol, John G. Gunderson, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: We examined the predictive power of the self-harm subscale of the Schedule for Nonadaptive and Adaptive Personality (SNAP) to identify suicide attempters in the Collaborative Longitudinal Study of Personality Disorders (CLPS).

Method: The SNAP, a self-report personality inventory, was administered to 733 CLPS participants at baseline, of whom 701 (96%) had at least 6 months of follow-up data. Cox proportional hazards regression analyses were performed to examine the SNAP–self-harm subscale (SNAP- SH) in predicting the 129 suicide attempters over 8 years of follow-up. Possible moderators of prediction were examined, including borderline personality disorder, major depressive disorder (MDD), and substance …

Comparing The Temporal Stability Of Self-Report And Interview Assessed Personality Disorder, Douglas B. Samuel, Christopher J. Hopwood, Emily B. Ansell, Leslie C. Morey, Charles A. Sanislow, John C. Markowitz, Shirley Yen, M. Tracie Shea, Andrew E. Skodol, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

Findings from several large-scale, longitudinal studies over the last decade have challenged the long-held assumption that personality disorders (PDs) are stable and enduring. However, the findings, including those from the Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000), rely primarily on results from semistructured interviews. As a result, less is known about the stability of PD scores from self-report questionnaires, which differ from interviews in important ways (e.g., source of the ratings, item development, and instrument length) that might increase temporal stability. The current study directly compared the stability of the Diagnostic and Statistical Manual of Mental Disorders …

Ten-Year Course Of Borderline Personality Disorder: Psychopathology And Function From The Collaborative Longitudinal Personality Study, John G. Gunderson, Robert L. Stout, Thomas H. Mcglashan, M. Tracie Shea, Leslie C. Morey, Carlos M. Grilo, Mary C. Zanarini, Shirley Yen, John C. Markowitz, Charles A. Sanislow, Emily B. Ansell, Anthony Pinto, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Context: Borderline personality disorder (BPD) is traditionally considered chronic and intractable.

Objective: To compare the course of BPD’s psychopathology and social function with that of other personality disorders and with major depressive disorder (MDD) over 10 years. Design: A collaborative study of treatment-seeking, 18- to 45-year-old patients followed up with standardized, reliable, and repeated measures of diagnostic remission and relapse and of both global social functioning and subtypes of social functioning.

Setting: Nineteen clinical settings (hospital and outpatient) in 4 northeastern US cities.

Participants: Three study groups, including 175 patients with BPD, 312 with cluster C personality disorders, and 95 …

Can Personality Disorder Experts Recognize Dsm-Iv Personality Disorders From Five-Factor Model Descriptions Of Patient Cases?, Benjamin M. Rottman, Nancy S. Kim, Woo-Kyoung Ahn, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

Background: Dimensional models of personality are under consideration for integration into the next Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but the clinical utility of such models is unclear.

Objective: To test the ability of clinical researchers who specialize in personality disorders to diagnose personality disorders using dimensional assessments and to compare those researchers’ ratings of clinical utility for a dimensional system versus for the DSM-IV.

Method: A sample of 73 researchers who had each published at least 3 (median = 15) articles on personal- ity disorders participated between December 2008 and January 2009. The Five-Factor Model (FFM), one …

The Association Of Personality Disorders With The Prospective 7-Year Course Of Anxiety Disorders, Emily B. Ansell, Anthony Pinto, Maria O. Edelen, John C. Markowitz, Charles A. Sanislow, Shirley Yen, Mary C. Zanarini, Andrew E. Skodol, M. Tracie Shea, Leslie C. Morey, John G. Gunderson, Thomas H. Mcglashan, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

Background. This study prospectively examined the natural clinical course of six anxiety disorders over 7 years of follow-up in individuals with personality disorders (PDs) and/or major depressive disorder. Rates of remission, relapse, new episode onset and chronicity of anxiety disorders were examined for specific associations with PDs.

Method. Participants were 499 patients with anxiety disorders in the Collaborative Longitudinal Personality Disorders Study, who were assessed with structured interviews for psychiatric disorders at yearly intervals throughout 7 years of follow-up. These data were used to determine probabilities of changes in disorder status for social phobia (SP), generalized anxiety disorder (GAD), obsessive-compulsive …

The Role Of Problem Orientation Cognitive Distortions In Depression And Anxiety Intervention For Young Adults., Coralie Wilson

Coralie J Wilson

Interventions that aim to improve social problem-solving skills can significantly reduce the severity of anxiety and depression symptoms in young people. Anxious and depressed individuals often have a negative orientation to problem solution which acts as a barrier to implementing problem-solving skills. Research with older adults suggests that symptoms impair problem-solving abilities through cognitive processes associated with the development of anxiety and depression. In this study we extend previous investigations by assessing the extent to which specific cognitive distortions and symptoms of anxiety and depression are associated with negative problem orientation in a sample of 285 young adults aged 18 …

Rural Adolescents’ Help Seeking Intentions For Emotional Problems: The Influence Of Perceived Benefits And Stoicism., Coralie Wilson

Coralie J Wilson

This paper is the second from a larger multi-cite study developed and led by the third author which explores factors that influence adolescents' help-seeking intentions. Specifically, this paper investigates the extent to which perceived benefits of help seeking, stoicism, gender and symptoms of psychological distress are associated with intentions to seek professional help for emotional problems. A cross sectional self-report questionnaire was administered to adolescents recruited from seven high schools in rural towns in the Riverina region of New South Wales. A total of 778 adolescents were recruited. The sample included 373 male and 404 female participants between 13 and …

Predicting Adolescents’ Future Intentions To Seek Help For Mental Health Problems., Coralie J. Wilson

Frank Deane

This study examined whether high school students’ current symptoms of general psychological distress, self-rated social problem-solving skills, and recent help-seeking experiences predict their future intentions to seek help for a mental health problem. At Time 1, 98 high school students, aged 12-17 years, completed the study self-report survey that included measures of psychological distress, social problem-solving skill, and recent help-seeking behaviour. At Time 2, three weeks later, the same students completed measures of help-seeking intentions. Students with more severe levels of distress symptoms at Time 1 had lower intentions to seek help for a mental health problem at Time 2. …

Personality Assessment In Dsm--5: Empirical Support For Rating Severity, Style, And Traits, Christopher J. Hopwood, Johanna C. Malone, Emily B. Ansell, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, Anthony Pinto, John C. Markowitz, M. Tracie Shea, Andrew E. Skodol, John G. Gunderson, Mary C. Zanarini, Leslie C. Morey

Charles A. Sanislow, Ph.D.

Despite a general consensus that dimensional models are superior to the categorical representations of personality disorders in DSM-IV, proposals for how to depict personality pathology dimensions vary substantially. One important question involves how to separate clinical severity from the style of expression through which personality pathology manifests. This study empirically distinguished stylistic elements of personality pathology symptoms from the overall severity of personality disorder in a large, longitudinally assessed clinical sample (N = 605). Data suggest that generalized severity is the most important single predictor of current and prospective dysfunction, but that stylistic elements also indicate specific areas of difficulty. …

Rural Adolescents’ Help Seeking Intentions For Emotional Problems: The Influence Of Perceived Benefits And Stoicism., Coralie J. Wilson

Frank Deane

This paper is the second from a larger multi-cite study developed and led by the third author which explores factors that influence adolescents' help-seeking intentions. Specifically, this paper investigates the extent to which perceived benefits of help seeking, stoicism, gender and symptoms of psychological distress are associated with intentions to seek professional help for emotional problems. A cross sectional self-report questionnaire was administered to adolescents recruited from seven high schools in rural towns in the Riverina region of New South Wales. A total of 778 adolescents were recruited. The sample included 373 male and 404 female participants between 13 and …

The Effects Of Need For Autonomy And Preference For Seeking Help From Informal Sources On Emerging Adults’ Intentions To Access Mental Health Services For Common Mental Disorders And Suicidal Thoughts., Coralie J. Wilson

Coralie J Wilson

Emerging or early adulthood is the life stage spanning 18-25 years of age. In Australia, anxiety and affective disorders (often classified as ‘common mental disorders’) are prevalent in this age group and suicide is also a concern. Professional mental health care can reduce the long-term impact of these mental health problems and protect against the development of severe forms of these disorders. However, up to three-quarters of young people with mental health needs do not seek professional help for their condition. This study aimed to examine the extent to which belief in the need for autonomy and intentions to seek …

Personality Disorders Predict Relapse After Remission From An Episode Of Major Depressive Disorder: A 6-Year Prospective Study, Carlos M. Grilo, Robert L. Stout, John C. Markowitz, Charles A. Sanislow, Emily B. Ansell, Andrew E. Skodol, Donna S. Bender, Anthony Pinto, M. Tracie Shea, Shirley Yen, John G. Gunderson, Leslie C. Morey, Christropher J. Hopwood, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: To examine prospectively the course of major depressive disorder (MDD) and to test for the moderating effects of personality disorder (PD) comorbidity on relapse after remission from an episode of MDD.

Method: Participants were 303 patients (196 women and 107 men) with current DSM-IV diagnosed MDD at baseline enrollment in the Col­laborative Longitudinal Personality Disorders Study. Major depressive disorder and Axis I psychiatric disorders were assessed with the Structured Clinical Interview for DSM-IV, and Axis II PDs were assessed with the Diagnostic Interview for DSM-IV Personality Disorders. The course of MDD was assessed with the Longitudinal Interval Follow­up Evaluation …

Developing Constructs For Psychopathology Research: Research Domain Criteria, Charles A. Sanislow, Daniel S. Pine, Kevin J. Quinn, Michael J. Kozak, Marjorie A. Garvey, Robert K. Heinssen, Philip Sung-En Wang, Bruce N. Cuthbert

Charles A. Sanislow, Ph.D.

There exists a divide between findings from integrative neuroscience and clinical research focused on mechanisms of psychopathology. Specifically, a clear correspondence does not emerge between clusters of complex clinical symptoms and dysregulated neurobiological systems, with many apparent redundancies. For instance, many mental disorders involve multiple disruptions in putative mechanistic factors (e.g., excessive fear, deficient impulse control), and different disrupted mechanisms appear to play major roles in many disorders. The Research Domain Criteria (RDoC) framework is a heuristic to facilitate the incorporation of behavioral neuroscience in the study of psychopathology. Such integration might be achieved by shifting the central research focus …