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Misophonia is a chronic condition in which specific sounds cause intense negative emotions and autonomic arousal. Misophonia is considered a psychological disorder without any relationship with specific alterations of hearing receptors and independent from physical characteristics of the sound. Moreover if misophonia can be defined as a specific psychiatric disorder or a correlate of other conditions is still under debate. The patients were two women and one man. In this case series we first identified the presence of triggers sounds inducing misophonia as reported during the psychotherapy sessions. At a qualitative level all the three patients perceived that the others were intentionally acting with the purpose of underline their maladaptive interpersonal schemas. All the patients were evaluated with the use of questionnaires. Regarding personality disorders (PD) all three patients suffered from at least one PD. As regard depression, one had moderate depression and one had severe depression. Two patients had moderate/severe anxiety. All the three patients can be considered as highly problematic in the interpersonal domain. Our findings have clinical implications for the treatment of misophonia because it seems to be sustained by underlying PD or maladaptive interpersonal schemas. The qualitative analysis of these cases has highlighted how patients with misophonia tended to ascribe intentionality to the people who emit the sounds that trigger their negative emotional reactions. Further studies are necessary to evaluate which kind of interpersonal patterns occur in these patients. [ABSTRACT FROM AUTHOR]

People with epilepsy often suffer psychiatric symptoms or exhibit maladaptive personality characteristics which can impact them more than seizures. This case illustrates a selective association of a Theory of Mind dysfunction, including an impaired comparison of reality and others' behavior, with an obsessive-compulsive personality disorder in a patient with left temporal lobe epilepsy and crossed cognitive functions. The patient revealed visual memory deficits and impaired interpretation of other people's behavior, mental rigidity, and a tendency to formulate inflexible judgements. Moreover, she shows impairment in understanding and sharing the emotional states of others in reference to herself (Empathic Quotient); her social relations are limited to her parents. Patients with right temporal lobe epilepsy frequently report persistent and rigid actions and thoughts, and this can have substantial psychological and social consequences for everyday life. We suggest that this could be a case of crossed cognitive functions, in particular ToM, and crossed psychobehavioral functions linked to right-hemisphere damage. [ABSTRACT FROM AUTHOR]

Personality disorders have a deleterious impact on individual quality of life, and are associated with a significant social burden. Despite a broad range of presentations across the various personality disorders, clinical research has shown a strong bias toward borderline personality disorder. In contrast to the emotional dysregulation of borderline personality disorder, a number of personality disorders are characterised by emotional inhibition and alexithymia. Research increasingly suggests that these deficits in emotional regulation may be symptomatic of problems with metacognition—the ability to identify, understand, and influence mental states. Research and specific treatment approaches are needed which target personality dysfunction characterised by emotional inhibition, rather than dysregulation. Emerging evidence suggests that metacognitive interpersonal therapy may be an effective treatment approach for personality disorders characterised by emotional inhibition. The current case study provides an in-depth examination of the application of metacognitive interpersonal therapy for a man diagnosed with comorbid avoidant personality disorder, and obsessive compulsive personality disorder. The patient described a history of bullying and unmet needs throughout his childhood, resulting in maladaptive interpersonal schemas and metacognitive deficits. Treatment focused on building the patient's ability to identify and understand his mental states, and targeted schema-driven behaviour. The patient reported experiencing the therapy as helpful, and stated that it contributed to a marked improvement in his quality of life. Results indicate that a 1 year intervention was successful in achieving diagnostic recovery and symptom reduction, supporting metacognitive interpersonal therapy as an effective intervention. [ABSTRACT FROM AUTHOR]

Because stability over time is central to the definition of personality disorder, aim of the current study was to determine the stability of the Pregnancy Obsessive-Compulsive Personality Disorder (OCPD) Symptoms Checklist ( N = 199 women). Strong positive correlations between assessments at 32 weeks of pregnancy and 2 and 3-3.5 years after childbirth were found ( r between .62-.72), and the group mean score did not change over time. The Pregnancy OCPD Symptoms Checklist assesses stable, trait-like symptoms of OCPD. [ABSTRACT FROM AUTHOR]

Scrupulosity is a subtype of obsessive-compulsive disorder (OCD) defined by religious or moral fears. Although the relationship between personality and OCD has been extensively studied, it remains unclear how personality relates specifically to religious obsessions and scrupulous fears. In the current study, we examined the association between scrupulosity and personality characteristics, including the Five Factor Model (FFM) and obsessive-compulsive personality disorder (OCPD), in a sample of individuals with self-reported obsessive-compulsive (OC) symptoms. Seventy-nine participants completed an anonymous online survey. FFM traits did not, but OCPD traits did, explain a significant amount of variance in scrupulosity. We also replicated previous findings showing that individuals with greater OC symptoms score lower on Extraversion and higher on Neuroticism. These findings suggest that scrupulous symptoms may not be specifically linked with any of the FFM personality factors, but may be associated with OCPD. Findings are discussed in the context of cognitive-behavioral theory and practice. [ABSTRACT FROM AUTHOR]

This review provides a current overview on the diagnostics, epidemiology, co-occurrences, aetiology and treatment of obsessive-compulsive personality disorder (OCPD). The diagnostic criteria for OCPD according to the recently published Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) include an official set of criteria for clinical practice and a new, alternative set of criteria for research purposes. OCPD is a personality disorder prevalent in the general population (3-8 %) that is more common in older and less educated individuals. Findings on sex distribution and course of OCPD are inconsistent. OCPD is comorbid with several other medical and psychological conditions. As for causes of OCPD, most empirical evidence provides support for disturbed attachment as well as the heritability of OCPD. So far, cognitive (behavioural) therapy is the best validated treatment of OCPD. Self-esteem variability, stronger early alliances as well as the distress level seem to predict cognitive (behavioural) therapy outcome. Future research is needed to further advance knowledge in OCPD and to resolve inconsistencies. [ABSTRACT FROM AUTHOR]

An 'Alternative DSM-5 Model for Personality Disorders' was published in Sect. III of DSM-5, while the identical categories and criteria from DSM-IV for the personality disorders (PDs) are in Sect. II. Given strong shifts from categorical diagnoses toward dimensional representations in psychiatry, how did the PDs end up 'stuck in neutral,' with the flawed DSM-IV model perpetuated? This article reviews factors that influenced the development of the new model and data to encourage and facilitate its use by clinicians. These include recognizing 1) a dimensional structure for psychopathology for which personality may be foundational; 2) a consensus on the structure of normal and abnormal personality; 3) the clinical significance of personality; 4) PD-specific severity required to establish disorder; 5) disruption, discontinuity, and perceived clinical utility of the Alternative Model may not be problems; and 6) a way forward involving collaborative research on neurobiological and psychosocial processes, treatment planning, and outcomes. [ABSTRACT FROM AUTHOR]

Joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type (JHS/EDS-HT) is a largely unrecognized, heritable connective tissue disorder, mainly characterized by joint instability complications, widespread musculoskeletal pain, and minor skin features. In a case-control study, 47 consecutive JHS/EDS-HT patients were investigated for the prevalence of psychiatric disorders and compared to 45 healthy controls in a single center. The psychiatric evaluation consisted of structured clinical interview for DSM-IV criteria by using the SCID-I and the SCID-II. Symptom severity was assessed using the Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), and the Brief Psychiatric Rating Scale (BPRS). The Global Assessment of Functioning Scale (GAF) was used to assess the overall severity of psychological, social, and occupational functions. JHS/EDS-HT patients had significantly higher mean scores for all questionnaires: HAM-A (6.7 vs. 3.8), HAM-D (6.4 vs. 2.7), GAF (75.0 vs. 86.1), and BPRS (27.5 vs. 25.6). The JHS/EDS-HT group had a 4.3 higher risk of being affected by any psychiatric disorder, and in particular, a 5.8 higher risk of having a personality disorder. In particular, 5 JHS/EDS-HT suffered from obsessive-compulsive personality disorder with an observed prevalence rate of 10.6 % (3.6-23.1). Psychiatric assessment of JHS/EDS-HT patients showed an extremely high prevalence of personality disorders (21 %), and of Axis-I disorders (38 %), mostly depressive. This study did not confirm the previously reported increased rate of panic disorders in JHS/EDS-HT. [ABSTRACT FROM AUTHOR]

The validity of the Axis II Obsessive-Compulsive Personality Disorder (OCPD) category and its position within the Cluster C personality disorder (PDs) section of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, APA ) continues to be a source of much debate. The present study examines the associations between general and maladaptive personality traits and OCPD symptoms, prior to and after controlling for co-occurring PD variance, in a general population sample of 274 Flemish adolescents and further explores the incremental validity of two different maladaptive trait measures beyond general traits. The results demonstrate that the number of (general and maladaptive) personality-OCPD associations decreases after controlling for a general personality pathology factor, with the FFM factor Conscientiousness and its maladaptive counterpart Compulsivity as remaining correlates of OCPD. The findings further suggest to complement the general NEO-PI-R (Costa and McCrae 1992) scales with more maladaptive items to enable a more comprehensive description of personality pathology variance. Implications for understanding and assessing OCPD in the developmental context of adolescence are discussed. [ABSTRACT FROM AUTHOR]

The present study evaluated whether different patterns of temperament may predict a different threshold of acceptability of obsessive-compulsive (OC) symptoms in adolescents. OC symptomatology was detected with the Leyton Obsessional Inventory-Child Version (LOI-CV) and temperament was assessed using the tridimensional personality questionnaire in 2,775 high-school students. According to the LOI-CV scores, the adolescents were classified as high interference (interfering, ego-dystonic symptoms) (HI), supernormal (noninterfering, ego-syntonic symptoms) (Sn) and controls (C) HI were 119 (4.3%), Sn 85 (3.1%) and C 2,571 (92.6%). The best predictor of belonging to HI or Sn groups was the temperament configuration of high Harm Avoidance (HA) and high Persistence (P). The feature that mainly distinguishes the two symptomatic groups were Novelty Seeking (NS) levels. Our data suggest that people characterized by pessimistic worry in anticipation of future problems, passive avoidant behaviour, rapid fatigability (high HA) and irresoluteness, ambitiousness, perseverance, perfectionism, enduring feelings of frustration (high P) might develop OC symptoms. Whether OC symptoms become ego-syntonic or ego-dystonic seems to mainly depend on NS levels: low NS might protect people (with the prevention of “exploratory and active behaviours” that may elicit loss of control on symptoms) from the development of interfering OC symptoms. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the presence of obsessive-compulsive personality disorders (OCPeD) in newly diagnosed, drug-naive Parkinson's disease (PD) patients. Topics discussed include symptoms of OCPeD, the higher OCPeD frequency among drug-naive PD patients, and the hypothesis that OCPeD could be an early manifestation of PD.