Borderline Conditions and Pathological Narcissism

Drug addiction is a pathological state; the disorder involves the progression of acute drug use to the development of drug seeking behavior. The diagnostic and statistical manual of mental disorders, 4th edition, categorized three stages of drug addictions preoccupation, anticipation, binge intoxication and withdrawal or negative effect. These stages are characterized respectively by constant craving and preoccupation with obtaining the substance, using more of the substance and experience the necessary intoxicating effects and experiencing tolerance withdrawal symptoms and decrease motivation of normal life activities.

Diagnostic And Statistical Manual Of Mental Disorders 4th Edition

In this chapter, we will outline how the concept of mentalizing helps us understand some of the common problems associated with borderline personality disorder and how the theoretical understanding is translated into psychotherapeutic intervention. Mentalizing is the process by which we interpret the actions of ourselves and others in terms of underlying intentional states such as personal desires, needs, feelings, beliefs and reasons. This capacity develops within the context of attachment relationships during infancy and childhood. Borderline personality disorder is conceived of as being a disorder of mentalizing. Vulnerability to a loss in mentalizing particularly in interpersonal or stressful circumstances is a core feature of the disorder. If treatment is to be successful it must either have mentalization as its focus or at the very least stimulate development of mentalizing as an epiphenomenon. Treatment focusing on mentalizing itself is described. © Copyright (c) by The Haworth Press, Inc. All rights reserved.

Mentalization-based treatment for BPD

Gender differences in the prevalence of nonsuicidal self-injury: A meta-analysis

Severe Personality Disorders: Psychotherapeutic Strategies

We aim to provide quantitative evidence on the psychological impact of epidemic/pandemic outbreaks (i.e., SARS, MERS, COVID-19, ebola, and influenza A) on healthcare workers (HCWs). Forty-four studies are included in this review. Between 11 and 73.4% of HCWs, mainly including physicians, nurses, and auxiliary staff, reported post-traumatic stress symptoms during outbreaks, with symptoms lasting after 1–3 years in 10–40%. Depressive symptoms are reported in 27.5–50.7%, insomnia symptoms in 34–36.1%, and severe anxiety symptoms in 45%. General psychiatric symptoms during outbreaks have a range comprised between 17.3 and 75.3%; high levels of stress related to working are reported in 18.1 to 80.1%. Several individual and work-related features can be considered risk or protective factors, such as personality characteristics, the level of exposure to affected patients, and organizational support. Empirical evidence underlines the need to address the detrimental effects of epidemic/pandemic outbreaks on HCWs’ mental health. Recommendations should include the assessment and promotion of coping strategies and resilience, special attention to frontline HCWs, provision of adequate protective supplies, and organization of online support services.

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The Psychological Impact of Epidemic and Pandemic Outbreaks on Healthcare Workers: Rapid Review of the Evidence.

Personality traits, family environment and maltreatment episodes are often associated with nonsuicidal self-injury (NSSI); however, research on these associations has shown mixed results. The aim of the present study was to clarify the effects of these factors on the presence and the severity of NSSI among a sample of Italian students who attended secondary schools (N = 267, mean age = 17.03 SD = 0.866). The results showed that personality traits, family environment and maltreatment differently predicted the presence and the severity of NSSI. Self-injurers were more impulsive and aggressive than non-self-injurers and reported poorer relationship quality with their mothers and more sexual and physical abuse episodes than non-self-injurers. Conversely, the frequency of NSSI behaviours was predicted by the presence of less impulsiveness, more anxiety and aggressiveness, poorer relationship quality with both parents and a lower degree of identification with the father. Finally, more frequent self-injurers also reported more sexual abuses and neglect episodes than less frequent self-injurers.

Adolescent nonsuicidal self-injury: the effects of personality traits, family relationships and maltreatment on the presence and severity of behaviours.

We report evidence on the negative psychological effects of pandemics in people with personality disorders (PDs) and on the role of personality pathology in compliance with mitigation-related behaviors. Considering the paucity of studies, after a description of the main features of PDs, on the basis of the current literature on pandemic and quarantine mental health impact, we trace some clinical hypotheses. Paranoid traits and detachment (cluster A) might lead to worse psychological outcomes. Cluster B patients may show more intense stress-related reactions and react strongly to social distancing, especially considering borderline personality disorder. Cluster C patients might be particularly prone to anxiety and stress due to fear of contagion and may be less flexible in adaptation to new routines. Evidence on compliance with mitigation measures is mixed, with lower compliance in cluster B patients and higher in cluster C ones. We suggest that PD patients might be particularly affected by pandemics. Furthermore, they might react differently, according to their main diagnosis. Similarly, compliance with mitigation measures may differ according to specific PDs. Our results should be considered as a starting point to reflect on therapeutic strategies to be adopted in the post-COVID-19 situation.

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Personality Disorders in Time of Pandemic.

Objective: Whilst the relationship between narcissism and self-esteem has been studied for a long time, findings are still controversial. The majority of studies investigated narcissistic grandiosity, neglecting the existence of vulnerable manifestations of narcissism. Moreover, recent studies have shown that grandiosity traits are not always associated with inflated explicit self-esteem. The aim of the present study is to investigate the relationship between narcissistic traits and explicit self-esteem, distinguishing between grandiosity and vulnerability. Moreover, we consider the role of implicit self-esteem in qualifying these associations. Method: Narcissistic traits, explicit and implicit self-esteem measures were assessed among 120 university students (55.8% women, Mage = 22.55, SD = 3.03). Results: Results showed different patterns of association between narcissistic traits and explicit self-esteem, depending on phenotypic manifestations of narcissism. Narcissistic vulnerability was linked to low explicit self-evaluations regardless of one’s levels of implicit self-esteem. On the other hand, the link between narcissistic grandiosity and explicit self-esteem was qualified by levels of implicit self-views, such that grandiosity was significantly associated with inflated explicit self-evaluations only at either high or medium levels of implicit self-views. Discussion: These findings showed that the relationship between narcissistic traits and explicit self-esteem is not univocal, highlighting the importance of distinguishing between narcissistic grandiosity and narcissistic vulnerability. Finally, the study suggested that both researchers and clinicians should consider the relevant role of implicit self-views in conditioning self-esteem levels reported explicitly by individuals with grandiose narcissistic traits.

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Rossella Di Pierro

Papers

The Psychological Impact of Epidemic and Pandemic Outbreaks on Healthcare Workers: Rapid Review of the Evidence.

Adolescent nonsuicidal self-injury: the effects of personality traits, family relationships and maltreatment on the presence and severity of behaviours.

Personality Disorders in Time of Pandemic.

Narcissistic traits and explicit self-esteem: The moderating role of implicit self-view

Mental and physical health in family members of substance users: A scoping review.