Self-Reported ICD-11 Personality Disorder Severity in Peruvian Adolescents: Structure, Validity, and Tentative Cutoffs.

Personality disorder (PD) is particularly common in adolescents, which underscores the significance of early screening, diagnosis, and intervention. To date, the definition of PD in the new ICD-11 has not yet been investigated in adolescents. This study therefore aimed to investigate the unidimensionality and criterion validity of self-reported ICD-11 PD features in Peruvian adolescents using the Personality Disorder Severity ICD-11 (PDS-ICD-11) scale. A total of 1,073 students (63% female; age range 12-16 years) were administered the PDS-ICD-11 scale along with criterion measures of personality pathology and symptom distress. The PDS-ICD-11 score showed adequate unidimensionality and conceptually meaningful associations with external criterion variables. The findings indicate that ICD-11 PD features, as measured with the PDS-ICD-11 scale, are structurally and conceptually sound when employed with adolescents. Norm-based cutoffs derived from the present study may be used for clinical interpretation. The PDS-ICD-11 may be employed as an efficient screening tool for personality dysfunction in adolescents.

Tracking Psychodynamic Foci: Trajectories Through the Therapeutic Process.

Brief psychodynamic psychotherapy has gained importance in current clinical practice. To achieve brevity, a focus must be established and worked through. Different conceptualizations have emphasized the relational patterns and/or conflict foci as central but adopting a mono-schematic approach. However, patients come to treatment with more than one issue that must be addressed. Thus, another focus must be included because of its relevance, i.e., personality functioning. The aims of this study were to identify the presence and depth level of three foci (relational pattern, conflict, and personality functioning) in episodes of change throughout the process, and to evaluate the relationship of each focus with the complexity of patients' change. Initial OPD foci and the presence and depth of each were evaluated in 13 successful brief psychodynamic therapies. Change episodes of those therapies were analyzed as well. Results showed differences between foci in the initial phase with a higher presence of conflict focus. Throughout the process, only the presence and level of personality functioning improved. Also, complexity of patients' change was related to conflict focus, specifically on the emergence of competence feelings. The results provide evidence and enrich process research of brief psychodynamic therapies.

Evaluación de la personalidad y resultados en cesación tabáquica

Resumen: Introducción: Los resultados en cesación tabáquica son insatisfactorios, menores al 30% al año de finalizado el tratamiento. No existe suficiente evidencia sobre la relación entre el Nivel de Funcionamiento de la Personalidad (NFP) y cesación. La Escala de NFP (ENFP) del Manual Estadístico de los Trastornos Mentales 5ed. que evalúa la personalidad en relación consigo mismo y con los otros a través de cuatro dominios, podría ser útil para predecir y mejorar resultados. Objetivos: Evaluar la asociación entre el NFP y la abstinencia al final del tratamiento y a los 6 meses. Metodología: Estudio longitudinal y analítico de una muestra no probabilística de pacientes que consultaron en una Unidad de Tabaquismo. Se aplicó test de chi2 o test exacto de Fisher para evaluar asociación de variables categóricas. Se evaluó NFP con la ENFP y grado de dependencia física con el Test de Fagerström. Resultados: Participaron 28 pacientes, 57% mujeres, edad promedio 48 años (± 12,3). 16 de los 28 cesaron, de ellos 14 presentaron bajos puntajes en la ENFP, correspondiente a mejor NFP. A menores alteraciones en el NFP, mayor cesación al final del tratamiento. En relación a los dominios, la cesación se asoció con identidad, autodirección y empatía y no así con intimidad. La mayoría de los pacientes con enfermedades tabaco-dependientes que presentaban alteraciones del NFP no logró cesar. Conclusiones: Los pacientes sin alteraciones del NFP, tienen más probabilidad de dejar y mantenerse sin fumar. Esto sugiere la utilidad de evaluar el NFP para predecir resultados en la cesación.

Abstract: Introduction: The smoking cessation results are unsatisfactory, less than 30% a year after the end of treatment. There is insufficient evidence on the relationship between the Level of Personality Functioning (LPF) and cessation. The LPF Scale (LPFS) of the Statistical Manual of Mental Disorders 5ed. that evaluates personality in relation to yourself and others, through four domains, could be useful in predicting and improving outcomes. Objectives: To assess the association between LPF and abstinence at the end of treatment and at 6 months. Methodology: Longitudinal and analytical study of a non-probability sample of patients who consulted in a Cessation Unit. The chi2 test or Fisher's exact test was applied to evaluate the association of categorical variables. LPF was evaluated with the LPFS and degree of nicotine dependence with the Fagerström Test. Results: 28 patients participated, 57% women, average age 48 years (± 12.3). 16 of 28 stopped, of them 14 had low scores in the LPFS, corresponding to better LPF. A less alteration in the LPF, greater cessation at the end of the treatment. Regarding the domains, the association was found with identity, self-direction and empathy with cessation but not with intimacy. Most of the patients with tobacco-dependent diseases who presented LPF disorder did not quit. Conclusions: Patients without LPF disorders are more likely to achieve cessation and remain abstinent. This assumes the utility of evaluating the LPF to predict cessation outcomes.

Resumo: Introdução: Os resultados da cessação do tabaco são insatisfatórios, menos de 30% ao ano após o término do tratamento. Não há suficiente evidência sobre a relação entre o Nível de Funcionamento da Personalidade (NFP) e a cessação. Escala NFP (ENFP) do Manual Estatístico de Transtornos Mentais 5 ed. que avalia a personalidade em relação a si mesmo e os outros, através de quatro domínios poderia ser útil para prever e melhorar os resultados. Objetivos: Avaliar associação entre NFP e abstinência ao final do tratamento e aos 6 meses. Metodologia: Estudo longitudinal, analítico de uma amostra não probabilística de pacientes consultados numa unidade de fumantes. Foram aplicados teste de Chi2 ou teste exato de Fisher para avaliar associação de variáveis categóricas. O NFP foi avaliado com ENFP e o grau de dependência física com Teste de Fagerström. Resultados: 28 pacientes participaram no estudo, 57% mulheres, idade média 48 anos (± 12,3). 16 dos 28 conseguirem cessar, 14 deles tiveram escores baixos do ENFP, correspondendo num melhor NFP. Quanto menos alterações no NFP, maior cessação ao final do tratamento. Em relação aos domínios, foi encontrada associação com identidade, autodireção e empatia com cessação, mas não é assim com intimidade. A maioria das pessoas com doenças dependentes do tabaco, que apresentavam alterações no PFN não conseguiu parar. Conclusões: Pacientes sem alterações no NFP têm maior probabilidade de cessação e permanecem livres de fumo. Isso sugere a utilidade de avaliar o NFP pra prever resultados na cessação.

Risk Factors for Adult Depression: Adverse Childhood Experiences and Personality Functioning.

Background: Depressive disorder is one of the main health problems worldwide. Many risk factors have been associated with this pathology. However, while the association between risks factors and adult depression is well established, the mechanisms behind its impact remains poorly understood. A possible, yet untested explanation is the mediating impact of levels of personality functioning, i.e., impairments with regard to self and interpersonal. Method: Around 162 patients were assessed at the beginning of their therapy, with regard to risk factors, such as sociodemographic, physical, hereditary (Information Form), and adverse childhood experiences (ACE; CTQ). Depressive symptoms (Beck Depression Inventory, BDI) and personality functioning (OPD-SQ) were also measured. Associations between the related variables as well as other possible covariates were examined by means of zero-order correlations and bootstrapping-based mediation analysis. Results: Of all the risk factors taken into account, level of education and physical illness were associated with depression. On the other hand, the most significant predictor of depressive symptomatology was ACE, and this relationship was mediated by personality functioning. This indicates that patients presenting adverse childhood experiences are more likely to develop deficiencies in personality functioning, which in turn increases their likelihood of developing depressive symptomatology. Conclusion: These results reaffirm the importance of incorporating risk and vulnerability factors such as personality functioning in understanding depression.