Psychotic-like experiences in pregnant and postpartum women without a history of psychosis.

OBJECTIVES: This study investigated whether psychotic-like experiences (PLEs) are prevalent amongst women in pregnancy and/or in the early postnatal phase, and whether the predictors identified in the literature for non-puerperal psychosis apply in a general sample of perinatal women. METHOD: 101 women in their third trimester of pregnancy completed questionnaire measures of mood, subjective well-being, sleep, expectations about labour, and PLEs. 66 of these participants also completed questionnaires shortly after giving birth. The main outcome measures were scores on the Peters Delusions Inventory (PDI) and the Launay-Slade Hallucination Scale-Revised (LSHS-R). RESULTS: During pregnancy, 80% of the samples endorsed at least one item on the PDI, and 76% endorsed at least one item on the LSHS-R. Endorsement rates were lower postnatally, with rates of 59% and 52% for the PDI and LSHS-R, respectively. Mean scores on the PDI were 3.07 during pregnancy and 1.61 postnatally. Mean scores on the LSHS-R were 8.38 during pregnancy and 5.24 postnatally. Hierarchical multiPLEs regression analyses revealed that ratings of depressive symptomatology significantly predicted PDI total score during pregnancy and LSHS-R total score postnatally, whilst postnatally, scores obtained on the PDI and LSHS-R postnatally were significantly predicted by scores on these measures during pregnancy. Fear in childbirth, but not in pregnancy, showed associations with PLEs but these associations were not maintained once multivariate analyses were conducted. CONCLUSIONS: The results of this study support the continuum model of psychosis, by illustrating that PLEs occur frequently in perinatal individuals without a diagnosis of severe mental illness.

Personality traits as predictors of inpatient aggression in a high-security forensic psychiatric setting: prospective evaluation of the PCL-R and IPDE dimension ratings.

The Dangerous and Severe Personality Disorder (DSPD) initiative in England and Wales provides specialized care to high-risk offenders with mental disorders. This study investigated the predictive utility of personality traits, assessed using the Psychopathy Checklist-Revised (PCL-R) and the International Personality Disorder Examination, with 44 consecutive admissions to the DSPD unit at a high-security forensic psychiatric hospital. Incidents of interpersonal physical aggression (IPA) were observed for 39% of the sample over an average 1.5-year period following admission. Histrionic personality disorder (PD) predicted IPA, and Histrionic, Borderline, and Antisocial PDs all predicted repetitive (2+ incidents of) IPA. PCL-R Factor 1 and Facets 1 and 2 were also significant predictors of IPA. PCL-R Factor 1 and Histrionic PD scores were significantly associated with imminence of IPA. Results were discussed in terms of the utility of personality traits in risk assessment and treatment of specially selected high-risk forensic psychiatric patients in secure settings.

Exploring the link between personality disorder and criminality in a community sample.

This study sought to identify, among a sample of 224 community residents with DSM-diagnosed personality disorder (PD), those personality and criminal history features associated with a combination of antisocial and borderline PDs (APD/BPD). After identifying first- and higher-order factors through factor analysis of IPDE item scores, forensic history and personality correlates of the identified higher-order factors were identified using regression analysis. Those having APD/BPD were more likely than the remainder to have received a conviction for violence and a custodial sentence. They showed higher trait anger and impulsivity and a greater history of aggression, and scored significantly higher on a higher-order "psychopathy" factor. In contrast, anankastic traits were inversely related to criminal history variables. It is concluded that APD/BPD represents a particularly criminogenic blend of traits likely to be overrepresented in high-secure forensic samples, and underrepresented in community PD samples. Future research should address the mechanisms through which PDs are related to criminality.