Biological Psychology Commons^™

Research Domain Criteria (Rdoc): Toward A New Classification Framework For Research On Mental Disorders, Thomas R. Insel, Bruce N. Cuthbert, Marjorie A. Garvey, Robert K. Heinssen, Daniel S. Pine, Kevin J. Quinn, Charles A. Sanislow, Philip S. Wang

Charles A. Sanislow, Ph.D.

Current versions of the DSM and ICD have facilitated reliable clinical diagnosis and research. However, problems have increasingly been documented over the past several years, both in clinical and research arenas (e.g., 1, 2). Diagnostic categories based on clinical consensus fail to align with findings emerging from clinical neuroscience and genetics. The boundaries of these categories have not been predictive of treatment response. And, perhaps most important, these categories, based upon presenting signs and symptoms, may not capture fundamental underlying mechanisms of dysfunction. One consequence has been to slow the development of new treatments targeted to underlying pathophysiological mechanisms.

Differential Impairment As An Indicator Of Sex Bias In Dsm-Iv Criteria For Four Personality Disorders., Christina D. Boggs, Leslie C. Morey, Andrew E. Skodol, M. Tracie Shea, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, Mary C. Zanarini, John G. Gunderson

Charles A. Sanislow, Ph.D.

This reprinted article originally appeared in Psychological Assessment, 2005, Vol. 17, (No. 4), 492–496. (The following abstract of the original article appeared in record 2005-16347-014.) The aim of the present study was to investigate the possibility of sex bias in the diagnostic criteria for borderline, schizotypal, avoidant, and obsessive–compulsive personality disorders. A clinical sample of 668 individuals was evaluated for personality disorder criteria using a semistructured interview, and areas of functional impairment were assessed with both self-report and semistructured interview. The authors used a regression model of bias to identify bias as differences in slopes or intercepts between men and …

The Construct Validity Of Rule-Breaking And Aggression In An Adult Clinical Sample, Christopher J. Hopwood, S. Alexandra Burt, John C. Markowitz, Shirley Yen, M. Tracie Shea, Charles A. Sanislow, Carlos M. Grilo, Emily B. Ansell, Thomas H. Mcglashan, John G. Gunderson, Mary C. Zanarini, Andrew E. Skodol, Leslie C. Morey

Charles A. Sanislow, Ph.D.

Previous research has demonstrated that aggression (AGG) and non-aggressive rule-breaking (RB) represent elements of antisocial behavior with different etiological mechanisms and associations to personality and psychopathology. However, these constructs have not been investigated in an adult clinical sample. In the current study, interview and self-report derived AGG and RB were associated with personality traits and disorders as well as functioning across several domains, family history, concurrent psychopathology, and prospective behaviors. Both AGG and RB were similarly related to disagreeableness. RB was uniquely related to low conscientiousness, cluster B personality disorders, functioning, problems in childhood, suicide risk, arrests, and substance use …

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

Charles A. Sanislow, Ph.D.

Objective: This article examined, using theories from cognitive science, the clinical utility of the Five-Factor Model (FFM) of Personality, an assessment and classification system under consideration for integration into the forthcoming fifth edition of the Diagnostic and Statistical Manual (DSM) of Mental Disorders. Specifically, the authors sought to test whether FFM descriptors are specific enough to allow practicing clinicians to capture core features of personality disorders.

Method: In two studies, a large nationwide sample of clinical psychologists, psychiatrists, and clinical social workers (N = 187 and N = 191) were presented case profiles based on symptom formats from either the …

New Onsets Of Substance Use Disorders In Borderline Personality Disorder Over 7 Years Of Follow-Ups: Findings From The Collaborative Longitudinal Personality Disorders Study, Marc Walter, John G. Gunderson, Mary C. Zanarini, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, Leslie C. Morey, Shirley Yen, Robert L. Stout, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Aims: The purpose of this study was to examine whether patients with borderline personality disorder (BPD) have a higher rate of new onsets of substance use disorders (SUD) than do patients with other personality disorders (OPD).

Design: This study uses data from the Collaborative Longitudinal Personality Disorder Study (CLPS), a prospective naturalistic study with reliable repeated measures over 7 years of follow-up.

Setting: Multiple clinical sites in four northeastern US cities.

Participants: A total of 175 patients with BPD and 396 patients with OPD (mean age 32.5 years) were assessed at baseline and at 6, 12, 24, 36, 48, 60, …

Psychological Distress And Change In A Pediatric Obesity Population, Amy Rebecca Beck

Loma Linda University Electronic Theses, Dissertations & Projects

Pediatric overweight and obesity is a growing national epidemic with 15 percent of children ages 6-19 considered obese and at least 22 percent considered overweight. While there is considerable research pointing to contributing factors of obesity, there is a paucity of research which elucidates what contributes to successful intervention. Considering that by the year 2050, nearly 50 million Americans may be obese, understanding the factors delineating success of weight loss and prevention is a necessity. The purpose of this study was to utilize archival data from the LLU Growing Fit Program to evaluate the levels of psychological distress experienced by …

New Episodes And New Onsets Of Major Depression In Borderline And Other Personality Disorders, John G. Gunderson, Robert L. Stout, Charles A. Sanislow, M. Tracie Shea, Thomas H. Mcglashan, Mary C. Zanarini, Maria T. Daversa, Carlos M. Grilo, Shirley Yen, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Background: In the context of much literature and conjecture about the relationship of personality disorders (PD) and major depressive disorder (MDD), this paper uses longitudinal data to assess the frequency with which PD patients, and especially those with borderline personality disorder (BPD), have recurrences (for patients with lifetime histories), or new onsets (for patients without lifetime histories) of MDD. Methods: A sample of 478 PD patients received reliable repeated follow-up assessments over a period of 6 years. The rates of new onsets and recurrences of MDD in all PD patients, and in BPD patients compared to OPD patients were analyzed. …

Comparison Of Alternative Models For Personality Disorders, Leslie C. Morey, Christopher J. Hopwood, John G. Gunderson, Andrew E. Skodol, M. Tracie Shea, Shirley Yen, Robert L. Stout, Mary C. Zanarini, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

BACKGROUND: The categorical classification system for personality disorder (PD) has been frequently criticized and several alternative dimensional models have been proposed.

METHOD: Antecedent, concurrent and predictive markers of construct validity were examined for three models of PDs: the Five-Factor Model (FFM), the Schedule for Nonadaptive and Adaptive Personality (SNAP) model and the DSM-IV in the Collaborative Study of Personality Disorders (CLPS) sample.

RESULTS: All models showed substantial validity across a variety of marker variables over time. Dimensional models (including dimensionalized DSM-IV) consistently outperformed the conventional categorical diagnosis in predicting external variables, such as subsequent suicidal gestures and hospitalizations. FFM facets …

Electromagnetic Differences In The Brain During Memory Retrieval, Warren Scott Merrifield

Loma Linda University Electronic Theses, Dissertations & Projects

The primary objectives for this experiment were to analyze the neuroanatomical correlates of autobiographical, episodic and semantic memory, use a different paradigm to promote episodic memory retrieval, and employ a different analysis technique to understand retrieval processes. Autobiographical and episodic memories are personal memories from the past. Autobiographical is more general (e.g. a street name of a house growing up) and episodic is more specific to time (e.g. 13th birthday party that took place on a street). For autobiographical and episodic memory retrieval operations, there is no general consensus as to the localization of function, but bilateral activation of the …

Descriptive And Longitudinal Observations On The Relationship Of Borderline Personality Disorder And Bipolar Disorder, John G. Gunderson, Igor Weinberg, Maria T. Daversa, Karsten D. Kueppenbender, Mary C. Zanarini, M. Tracie Shea, Andrew E. Skodol, Charles A. Sanislow, Shirley Yen, Leslie C. Morey, Carlos M. Grilo, Thomas H. Mcglashan, Robert L. Stout, Ingrid R. Dyck

Charles A. Sanislow, Ph.D.

OBJECTIVE: The purpose of this study was to test whether borderline personality disorder is a variant of bipolar disorder by examining the rates of co-occurrence in both disorders, the effects of co-occurrence on a longitudinal course, and whether the presence of either disorder confers the risk for new onsets of the other.

METHOD: A prospective repeated-measures design with reliable independent diagnostic measures and 4 years of follow-up was used to assess 196 patients with borderline personality disorder and 433 patients with other personality disorders.

RESULTS: Patients with borderline personality disorder had a significantly higher co-occurrence of bipolar disorder (19.4%) than …

Preliminary Evidence For Medication Effects On Functional Abnormalities In The Amygdala And Anterior Cingulate In Bipolar Disorder, Hilary P. Blumberg, Nelson H. Donegan, Charles A. Sanislow, Susan Collins, Cheryl Lacadie, Pawel Skudlarski, Ralitza Gueorguieva, Robert K. Fulbright, Thomas H. Mcglashan, John C. Gore, John H. Krystal

Charles A. Sanislow, Ph.D.

RATIONALE: Abnormal amygdala and frontocortical responses to emotional stimuli are implicated in bipolar disorder (BD) and have been proposed as potential treatment targets.

OBJECTIVES: The aim of this study was to investigate amygdala and frontocortical responses to emotional face stimuli in BD and the influences of mood-stabilizing medications on these responses.

METHODS: Functional magnetic resonance imaging was performed while 17 BD participants (5 unmedicated) and 17 healthy comparison (HC) participants viewed faces with happy, sad, fearful, or neutral expressions.

RESULTS: The group by stimulus-condition interaction was significant (p<0.01) for amygdala activation, with the greatest effects in the happy face condition. Relative to HC, amygdala increases were greater in unmedicated BD, but lower in medicated BD. Rostral anterior cingulate (rAC) activation was decreased in unmedicated BD compared to HC; however, BD participants taking medication demonstrated rAC activation similar to HC participants.

CONCLUSIONS: Although the sample sizes were small, these preliminary results suggest that …

Avoidant Personality Disorder And Social Phobia: Distinct Enough To Be Separate Disorders?, Elizabeth Ralevski, Charles A. Sanislow, Carlos M. Grilo, Andrew E. Skodol, John G. Gunderson, M. Tracie Shea, Shirley Yen, Donna S. Bender, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: Existing evidence from anxiety disorder research indicates that social phobics (SP) with avoidant personality disorder (AVPD) experience more anxiety and show more impairment than patients with SP alone. The purpose of this study was to examine whether in patients diagnosed with AVPD, the co-occurrence of SP adds to its severity. We hypothesized that the addition of SP will not add to the severity of AVPD alone.

Method: Two groups of patients (AVPD = 224; AVPD/SP = 101) were compared at baseline and 2 years later on multiple demographic and clinical variables.

Results: Patients with AVPD and an additional diagnosis …

Psychophysiological Reactivity To Traumatic And Abandonment Scripts In Borderline Personality And Posttraumatic Stress Disorders: A Preliminary Report, Christian G. Schmahl, Bernet M. Elzinga, Ulrich W. Ebner, Timothy Simms, Charles A. Sanislow, Eric Vermetten, Thomas H. Mcglashan, J. Douglas Bremner

Charles A. Sanislow, Ph.D.

Borderline personality disorder (BPD) is a highly prevalent and disabling condition linked to early stressors including traumatic abuse and abandonment. While much work has addressed traumatic events in childhood, little is known about the biological sequelae of BPD including how this disorder may be differentiated from other stressrelated disorders such as posttraumatic stress disorder (PTSD). The purpose of this study was to investigate psychophysiological effects of different types of stressful reminders in BPD and in PTSD. Psychophysiological measures including heart rate, skin conductance responses, systolic and diastolic blood pressure in response to standardized neutral scripts, and personalized scripts of traumatic …

Amygdala Hyperreactivity In Borderline Personality Disorder: Implications For Emotional Dysregulation, Nelson H. Donegan, Charles A. Sanislow, Hilary P. Blumberg, Robert K. Fulbright, Cheryl Lacadie, Pawel Skudlarski, John C. Gore, Ingrid R. Olson, Thomas H. Mcglashan, Bruce E. Wexler

Charles A. Sanislow, Ph.D.

BACKGROUND: Disturbed interpersonal relations and emotional dysregulation are fundamental aspects of borderline personality disorder (BPD). The amygdala plays important roles in modulating vigilance and generating negative emotional states and is often abnormally reactive in disorders of mood and emotion. The aim of this study was to assess amygdala reactivity in BPD patients relative to normal control subjects. We hypothesized that amygdala hyperreactivity contributes to hypervigilance, emotional dysregulation, and disturbed interpersonal relations in BPD.

METHODS: Using functional magnetic resonance imaging, we examined neural responses to 20-sec blocks of neutral, happy, sad, and fearful facial expression (or a fixation point) in 15 …

The Representation Of Four Personality Disorders By The Schedule For Nonadaptive And Adaptive Personality Dimensional Model Of Personality, Leslie C. Morey, Megan B. Warner, M. Tracie Shea, John G. Gunderson, Charles A. Sanislow, Carlos M. Grilo, Andrew E. Skodol, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

This study examined the relationships of the Schedule for Nonadaptive and Adaptive Personality (SNAP) model of personality to 4 targeted personality disorders (PDs) in a large multisite sample of patients. Data were examined from 529 patients, who were assigned 1 of 5 primary diagnoses: borderline, schizotypal, avoidant, and obsessive–compulsive PDs and major depression without PD. Patients were administered the SNAP questionnaire and results were compared among diagnostic groups and between patient groups and nonclinical norms. Results indicated that the dimensions of the model appear to have considerable promise in differentiating normal from abnormal personality, particularly in the propensity of individuals …

Neural Correlates Of Memories Of Abandonment In Women With And Without Borderline Personality Disorder, Christian G. Schmahl, Bernet M. Elzinga, Eric Vermetten, Charles A. Sanislow, Thomas H. Mcglashan, J. Douglas Bremner

Charles A. Sanislow, Ph.D.

BACKGROUND: Borderline personality disorder (BPD) is a common psychiatric disorder that is often linked to early stressors. One particularly salient feature of the disorder is fear of abandonment. This pilot study was conducted to measure neural correlates of memories of abandonment in women with and without BPD.

METHODS: Twenty women with a history of childhood sexual abuse underwent measurement of brain blood flow with positron emission tomography imaging while they listened to scripts describing neutral and personal abandonment events. Brain blood flow during exposure to abandonment and neutral scripts was compared among women with and without BPD.

RESULTS: Memories of …

Gender Differences In Borderline Personality Disorder: Findings From The Collaborative Longitudinal Personality Disorders Study, Dawn M. Johnson, M. Tracie Shea, Shirley Yen, Cynthia L. Battle, Caron Zlotnick, Charles A. Sanislow, Carlos M. Grilo, Andrew E. Skodol, Donna S. Bender, Thomas H. Mcglashan, John G. Gunderson, Mary C. Zanarini

Charles A. Sanislow, Ph.D.

A majority of the literature on borderline personality disorder (BPD) focuses on its occurrence in women or does not specifically assess for gender differences in clinical presentations. Some studies report that men with BPD may be more likely to be diagnosed with substance use disorders, as well as paranoid, passive-aggressive, narcissistic, sadistic, and antisocial personality disorders (PDs). Additionally, women with BPD appear to be more likely to report histories of adult physical and sexual abuse and to meet diagnostic criteria for post-traumatic stress disorder (PTSD) and eating disorders. The purpose of the present study was to further examine gender differences …

Plausibility And Possible Determinants Of Sudden 'Remissions' In Borderline Patients, John G. Gunderson, Donna S. Bender, Charles A. Sanislow, Shirley Yen, Jennifer Bame Rettew, Regina Dolan-Sewell, Ingrid R. Dyck, Leslie C. Morey, Thomas H. Mcglashan, M. Tracie Shea, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

THIS STUDY documents dramatic improvements in patients with borderline personality disorder (BPD) and explores their possible determinants. From a sample of the 160 carefully diagnosed borderline patients on whom prospective follow-along data was collected, a subsample of 18 was identified whose DSM-IV criteria count fell to two or fewer during the course of the first 6 months of the study and retained that improvement for the next 6 months. Follow-along data including month-by-month ratings of BPD criteria; week-by-week ratings of Axis I disorders, medication changes, and life events were then used to establish concensus ratings on four hypothesized causes: Axis …

Schizophrenia: A Critical Examination, Charles A. Sanislow, Robert C. Carson

Charles A. Sanislow, Ph.D.

No abstract provided.

The Cardiac Correlates Of Attention In The Denervated Heart: A Study Of Infant Heart Transplant Recipients, Stephanie Dianne Griffone

Loma Linda University Electronic Theses, Dissertations & Projects

The cardiac correlate of attention is a deceleration in heart rate, controlled by the parasympathetic division of the autonomic nervous system. This has been extensively studied in infants; the findings indicate that this deceleration is affected by a number of factors, several mediated by the vagus nerve. However, the effects of denervation on this response are not known. Studies with adult heart transplant recipients have shown attenuated acceleration in response to stressful mental tasks. This study investigated the cardiac response to attention in infants who had received a heart transplant, using a habituation paradigm. The hypothesis that they would show …

Locus Of Control, Coping, And Anticipatory Nausea In Women With Breast Cancer, Melinda L. Nielsen

Loma Linda University Electronic Theses, Dissertations & Projects

Many cancer patients experience adverse chemotherapy-related side effects. The present study examined whether the perception that one can control and effectively cope with her treatment for breast cancer mitigate against any nausea and vomiting that she may experience in anticipation of chemotherapy treatments. Seventy-five women with breast cancer completed the Multidimensional Health Locus of Control Scale - Form C, the Krantz Health Opinion Survey, the Ways of Coping Scale - Revised, and the Morrow Assessment of Nausea and Emesis. As hypothesized, internal health locus of control was significantly positively related to positive reappraisal coping strategies. This relationship was moderated by …

Relation Of Therapeutic Alliance And Perfectionism To Outcome In Brief Outpatient Treatment Of Depression, David C. Zuroff, Sidney J. Blatt, Stuart M. Sotsky, Janice L. Krupnick, Daniel J. Martin, Charles A. Sanislow, Sam Simmens

Charles A. Sanislow, Ph.D.

Prior analyses of the National Institute of Mental Health Treatment of Depression Collaborative Research Program demonstrated that perfectionism was negatively related to outcome, whereas both the patient's perception of the quality of the therapeutic relationship and the patient contribution to the therapeutic alliance were positively related to outcome across treatment conditions (S. J. Blatt, D. C. Zuroff, D. M. Quinlan, & P. A. Pilkonis, 1996; J. L. Krupnick et al., 1996). New analyses examining the relations among perfectionism, perceived relationship quality, and the therapeutic alliance demonstrated that (a) the patient contribution to the alliance and the perceived quality of the …

Short And Long-Term Effects Of Medication And Psychotherapy In The Brief Treatment Of Depression: Further Analyses Of Data From The Nimh Tdcrp, Sidney J. Blatt, David C. Zuroff, Colin M. Bondi, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

Prior analyses of data from the NIMH sponsored Treatment for Depression Collaborative Research Program (TDCRP; e.g., I. Elkin, 1994) indicated greater reduction of symptoms at midtreatment (8th wk) with Imipramine (IMI-CM) than with Cognitive-behavioral therapy (CBT) and Interpersonal therapy (IPT), but no significant differences in symptom reduction among these 3 active treatments at termination. Current analyses of previously unanalyzed data from ratings by therapists, clinical evaluators, and 162 patients (mean age 35 yrs) at termination and at 18-mo follow-up also indicated no significant differences among these treatments in symptom reduction or ratings of current clinical condition. But significant treatment differences …

Treatment Outcome Of Personality Disorders, Charles A. Sanislow, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: To review the treatment outcome of personality disorders.

Method: A literature search of studies pertaining to personality disorder and outcome was conducted, and studies that focused primarily on Axis II were retained. Of these, naturalistic outcome studies were distinguished from those that addressed treatment outcome specifically. The treatment outcome studies were examined in terms of type of treatment intervention, dependent variables, and outcome.

Results: Contrary to contemporary assumptions about Axis II, a substantial number of treatment outcome studies were identified. Trends in the assumptions underlying psychosocial and pharmacologic approaches were identified on the basis of dependent variables.

Conclusion: There …

The Schizophrenias, Robert Carson, Charles Sanislow

Charles A. Sanislow

No abstract provided.

Norm-Of-Reaction: Definition And Misinterpretation Of Animal Research, Steve A. Platt, Charles A. Sanislow

Charles A. Sanislow, Ph.D.

The development of a phenotype is due to an interaction of the genotype with the environment. Two terms have been used to describe the outcome of this interaction, the norm-of-reaction and the reaction range. The first represents the theoretically limitless distribution of the phenotypes that may be expressed by a given genotype. The reaction range implies an upper and lower limit for phenotype expression possible from a given genotype. A critical distinction between the reaction range and the norm-of-reaction is that the norm-of-reaction is a statement of the conceivable interactions found but does not imply any predictability other than that …