Personality Disorder Symptomatology and Neuropsychological Functioning in Closed Head Injury

Abstract

Despite an emerging literature characterizing the neuropsychological profiles of borderline, antisocial, and schizotypal personality disorders, relations between personality disorder traits and neurocognitive domains remain unknown. The authors examined associations among Millon Clinical Multiaxial Inventory-III personality disorder scales and eight neuropsychological domains in 161 patients referred for neuropsychological evaluation following closed head injury. Most personality disorder scales were associated with some decrement in cognitive function, particularly speeded processing, executive function, and language, while histrionic and narcissistic scales had positive relations with neuropsychological functioning. Results suggest that many personality disorder traits are related to neurocognitive function, particularly those functions subserved by frontal and temporal regions.

Distinguishing between Neuropsychological Malingering and Exaggerated Psychiatric Symptoms in a Neuropsychological Setting

“…While there is indeed evidence linking neuropsychological function to personality traits and psychopathology (Ruocco & Swirsky-Sacchetti, 2007;Ruocco & Trobst, 2003), evidence from the present study indicated that persons who feigned neuropsychological dysfunction rarely simultaneously exaggerated psychiatric symptomatology. Further exploration is needed to determine whether there are other relevant domains for which such dissociations might exist, both within and across psychological domains.…”

“…While this is indeed one possible account of these findings, there is emerging evidence to indicate that a substantial amount of variance is shared between scores on objective self-report personality inventories and neuropsychological tests (Ruocco & Swirsky-Sacchetti, 2007). As such, unshared method variance is likely unable to explain the obtained factor solution.…”

The sadistic trait predicts minimization of intention and causal responsibility in moral judgment

“…Importantly, different patterns of neuropsychological functioning were evidenced between sadistic personality disorder and antisocial personality disorder. Sadistic personality disorder was shown to be associated with emotional acting-out, defensive aggression and strong-willed determination (Ruocco & Swirsky-Sacchetti, 2007). These elements have critical implication in context of sadistic moral reasoning because they underscore poor emotional regulation.…”

Obstetric conditions and risk of first ever mental health contact during infancy, childhood and adolescence

“…It should be noted that fetal distress is a common reason for assisted delivery (OkunwobiSmith et al, 2000;Alfirevic et al, 2006;Simms, 2011) and is associated with cerebral palsy and brain injury among newborns (Nelson et al, 1996;Alfirevic, et al, 2006;Graham et al, 2006). It has been suggested that head and brain injury may be associated with increased risk of mental disorders (Whitnall et al, 2006;Ruocco and Swirsky-Sacchetti, 2007;Bombardier et al, 2010;Rao et al, 2010). A recent study which examined the association between obstetric conditions and risk of Schizophrenia found that persons who underwent manual extraction at birth had a significantly higher risk of Schizophrenia (Byrne et al, 2007).…”