Personality Traits and Disorders in Adolescents at Clinical High Risk for Psychosis: Toward a Clinically Meaningful Diagnosis

Boldrini, Tommaso; Tanzilli, Annalisa; Cicilia, Giuseppe Di; Gualco, Ivan; Lingiardi, Vittorio; Salcuni, Silvia; Tata, Maria Cristina; Vicari, Stefano; Pontillo, Maria

doi:10.3389/fpsyt.2020.562835

Cited by 14 publications

(14 citation statements)

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“…Although the results obtained can be considered promising, more studies would be needed. In this regard, Boldrini et al (2020) identified through the SWAP-200 the following prototypical characteristics of patients at high risk for psychosis: avoidance of social relationships, suspiciousness, obsessive thoughts, lack of psychological insight, dysphoric and overwhelming feelings of anxiety and depression, strange and abnormal reasoning processes or perceptual experiences, symptoms of depersonalization and derealization, and negative symptoms of avolition, abulia, blunted affectivity, and impaired role functioning. In addition, as stated by Sevilla-Llewellyn-Jones et al (2018) it is still not entirely clear to what extent personality may influence the development of psychosis.…”

Section: Discussionmentioning

confidence: 99%

Personality traits and transition to psychosis one year after the first assessment

et al. 2023

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IntroductionSeveral studies have identified ultra-high-risk criteria that may characterize an at-risk mental state and predict the transition of psychotic evolution. Personality traits may play a crucial role in this process.AimsThe current study aims to: (a) explore the evolution of an initial diagnosis over 12 months; (b) assess differences in social and occupational functioning; (c) identify common (trans-diagnostic) personality traits of psychotic risk.MethodsThe sample includes 97 (44 males and 53 females) young adults. They completed an assessment that consists of socio-demographic data, the Social and Occupational Functioning Scale, the Early Recognition Inventory-retrospective assessment onset of schizophrenia, and the Personality Inventory for DSM-5 (PID-5). According to the tests’ assessment, the sample was divided into three different groups: Ultra-High Risk (UHR), At-Risk, and Not at risk. One year after the first evaluation, psychiatrists administered the QuickSCID-5 to verify the diagnostic trajectories of the sample.ResultsOverall, the most prevalent category diagnoses were anxiety/depression, personality disorders, and psychosis. Specifically, the most common diagnosis in the UHR group was psychosis. Moreover, in the UHR group, the social and occupational functioning score was the lowest. In terms of differences in PID-5 personality traits, the At-risk and UHR groups scored highest in detachment and disinhibition. No statistically significant differences were found between the groups for negative affectivity, antagonism, and psychoticism traits.ConclusionResults obtained by the current study should be considered an attempt to better understand the diagnostic trajectories and trans-diagnostic personality traits in a group of young help-seekers, specifically in UHR. Findings highlight both the importance of diagnosis and personality traits evaluation to customize a specific intervention based on the level of psychotic risk. Clinical suggestions are reported.

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Section: Discussionmentioning

confidence: 99%

Personality traits and transition to psychosis one year after the first assessment

et al. 2023

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“…Given the high prevalence of personality disorders in ultra‐high‐risk patients (18% after 6 months, 22% after 1 year and 29% after 2 years to 36% after 3 years) compared to the relatively low rate of psychotic transition (Boldrini et al, 2019; Boldrini, Pontillo, et al, 2020a; Boldrini, Tanzilli, et al, 2020b; Fusar‐Poli et al, 2016; Sevilla‐Llewellyn‐Jones et al, 2018), intervention programs for at‐risk mental states patients should be supplements with personalized treatments that recognize, focus and treat maladaptive personality traits, to prevent transition to psychosis and promote psychological well‐being. Future research should investigate the relationship between psychopathological dimensions of personality and outcomes of early intervention programs for psychosis.…”

Section: Discussionmentioning

confidence: 99%

At‐risk mental states and personality traits: A cluster analysis approach on a group of help‐seeking young adults

Rossi

Salve

Biagianti

et al. 2023

Early Intervention Psych

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IntroductionResearch on the relationship between personality and psychosis onset is growing, with the goal of preventing or intervening early in patients' vulnerability. The identification of individuals with at‐risk mental states has enabled the development of early intervention strategies, such as Programma 2000, a youth mental health service that was implemented in Milan (Italy).AimsFocusing on the 18–25 age range—the time window with the highest incidence of psychotic onset—this study aims to identify the personality traits that may characterize the at‐risk mental states and the social functioning of a group of help‐seeking young adults.MethodsThe sample includes 169 people (48.5% males and 51.5% females). Data were collected during an initial assessment that comprised the Social and Occupational Functioning Assessment Scale, the Personality Inventory for DSM‐5, the Checklist ERIraos and a clinical session.ResultsResults identified a three‐cluster solution based on the Checklist scores: Cluster 1 ‘Not at psychotic risk’; Cluster 2 ‘At intermediate risk’; Cluster 3 ‘With psychotic onset’. The multivariate analysis of the variance of personality traits shows significant differences among the clusters in negative affect, detachment and disinhibition. Higher scores in these traits may distinguish individuals, not at psychotic risk from those at intermediate risk or with psychotic onset. Moreover, social functioning was found to be negatively associated with clusters of psychotic risk.ConclusionFindings from this study highlighted the need to evaluate personalized interventions targeting such personality traits that could prevent psychotic transition and promote psychological well‐being.

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“…MBT-P, moreover, could be helpful in preventing ( 53 , 54 ) from the onset of full-blown psychosis through improved long-term social functioning ( 53 , 55 ). In addition, dysfunctional personality traits are particularly prevalent in this population ( 56 , 57 ), and an estimated 40% of this population has a personality disorder in comorbidity ( 50 ), findings that can justify the application of treatment.…”

Section: Discussionmentioning

confidence: 99%

Mentalizing in individuals with state and trait risk for psychosis: a systematic review

De Salve,

Rossi,

Oasi

2023

Front. Psychiatry

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BackgroundMentalization is an umbrella concept defined as the ability to interpret one’s and others’ mental states. Previous studies have hypothesized that mentalization may be a crucial resilience factor that significantly moderates the likelihood of developing psychotic disorders in individuals with both state and trait risk factors for the illness.PurposeThe study reviews the role of mentalizing abilities (e.g., reflective functioning, Theory of Mind (ToM), and metacognition) in young adults with At-Risk Mental States (ARMS) and schizotypal traits. Specifically, the objective is to include articles that (a) evaluate the links between low mentalizing and both state (ARMS/CHR) and trait (schizotypy) risk for psychosis (b) compare the differences in mentalizing abilities between individuals with ARMS, schizotypy, full-blown psychosis, and healthy controls.MethodElectronic databases (PsycINFO, PubMed, Scopus, and Google Scholar) were used to search for articles, while Rayyan was employed to facilitate the screening and selection of studies. Eligible studies are original English-language; peer-reviewed research articles on populations that met validated risk diagnostic criteria for psychosis, ARMS, and healthy controls; empirical studies evaluating the association or differences between psychotic risk and mentalizing abilities. Non-English language studies, the ones not considering state or trait risk for psychosis, and qualitative studies were excluded. After the application of the PRISMA checklist and the inclusion and exclusion criteria previously mentioned, 10 articles were extracted. The systematic review has been registered on Prospero (CRD42023397594).ResultsLow levels of reflective functioning and metacognition may predict a transition to psychosis. In addition, reflective functioning and metacognitive impairments are associated with attenuated psychotic symptoms in both state risk groups and in non-clinical individuals with schizotypal traits. Concerning ToM tasks, mixed results emerged.ConclusionThe results obtained from the review suggest that the application of strategies to attenuate maladaptive metacognitive beliefs and low mentalization may be equally effective in improving psychotic symptoms. The assessment of mentalization and metacognition could potentially provide additional prognostic value over factors predisposing to psychosis. Good mentalization and metacognition functioning should be considered as protective factors able to minimize the transition to psychosis.

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Personality Traits and Disorders in Adolescents at Clinical High Risk for Psychosis: Toward a Clinically Meaningful Diagnosis

Cited by 14 publications

References 84 publications

Personality traits and transition to psychosis one year after the first assessment

Personality traits and transition to psychosis one year after the first assessment

At‐risk mental states and personality traits: A cluster analysis approach on a group of help‐seeking young adults

Mentalizing in individuals with state and trait risk for psychosis: a systematic review

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