Narcissism is associated with weakened frontostriatal connectivity: a DTI study

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Lynam, Donald R.; Powell, David K.; DeWall, C. Nathan

2016-01-01

Narcissism is characterized by the search for affirmation and admiration from others. Might this motivation to find external sources of acclaim exist to compensate for neurostructural deficits that link the self with reward? Greater structural connectivity between brain areas that process self-relevant stimuli (i.e. the medial prefrontal cortex) and reward (i.e. the ventral striatum) is associated with fundamentally positive self-views. We predicted that narcissism would be associated with less integrity of this frontostriatal pathway. We used diffusion tensor imaging to assess the frontostriatal structural connectivity among 50 healthy undergraduates (32 females, 18 males) who also completed a measure of grandiose narcissism. White matter integrity in the frontostriatal pathway was negatively associated with narcissism. Our findings, while purely correlational, suggest that narcissism arises, in part, from a neural disconnect between the self and reward. The exhibitionism and immodesty of narcissists may then be a regulatory strategy to compensate for this neural deficit. PMID:26048178

[Diderot medical chronicler in the Lettres à Sophie Volland].

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Richard-Pauchet, Odile

2007-01-01

The private diary Diderot wrote every week for the benefit of his mistress, Sophie Volland, gives an insight into "illness in letters" in the XVIIIth century. Diderot inserts the long story of his wife's illness (September-October 1762) into his monologue. Indeed, in general, health related topics are commonplace in letters. The health of the author is better expressed in autobiographical writing since this type of text aims to ascertain the author's sincerity: modern scholars have emphasized the "exhibitionism" inherent to Rousseau's Confessions. Diderot was the author of the French translation of Robert James' Dictionary of Medicine, and his continuing interest in the human body is revealed by his depiction of everyday life. The intensely active mind of the philosopher is incapable of locking itself into a love cocoon and Diderot must constantly reassert his presence in the world whatever happens. His correspondence can therefore be considered as an anthropological document containing evidence of the state of medicine in the days when the Encyclopaedia was written.

Narcissism is associated with weakened frontostriatal connectivity: a DTI study.

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Chester, David S; Lynam, Donald R; Powell, David K; DeWall, C Nathan

2016-07-01

Narcissism is characterized by the search for affirmation and admiration from others. Might this motivation to find external sources of acclaim exist to compensate for neurostructural deficits that link the self with reward? Greater structural connectivity between brain areas that process self-relevant stimuli (i.e. the medial prefrontal cortex) and reward (i.e. the ventral striatum) is associated with fundamentally positive self-views. We predicted that narcissism would be associated with less integrity of this frontostriatal pathway. We used diffusion tensor imaging to assess the frontostriatal structural connectivity among 50 healthy undergraduates (32 females, 18 males) who also completed a measure of grandiose narcissism. White matter integrity in the frontostriatal pathway was negatively associated with narcissism. Our findings, while purely correlational, suggest that narcissism arises, in part, from a neural disconnect between the self and reward. The exhibitionism and immodesty of narcissists may then be a regulatory strategy to compensate for this neural deficit. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Is the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, histrionic personality disorder category a valid construct?

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Bakkevig, Jonas F; Karterud, Sigmund

2010-01-01

The study investigated crucial aspects of the construct validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) histrionic personality disorder (HPD) category. The study included 2289 patients from the Norwegian Network of Psychotherapeutic Day Hospitals. Construct validity was assessed by means of prevalence, comorbidity with other personality disorders, internal consistency among HPD criteria, severity indices, as well as factor analyses. The prevalence of HPD was very low (0.4 %). The comorbidity was high, especially with borderline, narcissistic, and dependent personality disorders. The internal consistency was low. The criteria seemed to form 2 separate clusters: the first contained exhibitionistic and attention-seeking traits and the other contained impressionistic traits. The results indicated poor construct validity of the HPD category. Different options for the future of the category are discussed. The authors suggest the HPD category to be deleted from the DSM system. However, the clinical phenomena of exhibitionism and attention-seeking, which are the dominant personality features of HPD, should be preserved in an exhibitionistic subtype of narcissism. Copyright 2010 Elsevier Inc. All rights reserved.

Narcissism and consumer behaviour: a review and preliminary findings

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Cisek, Sylwia Z.; Sedikides, Constantine; Hart, Claire M.; Godwin, Hayward J.; Benson, Valerie; Liversedge, Simon P.

2014-01-01

We review the literature on the relation between narcissism and consumer behavior. Consumer behavior is sometimes guided by self-related motives (e.g., self-enhancement) rather than by rational economic considerations. Narcissism is a case in point. This personality trait reflects a self-centered, self-aggrandizing, dominant, and manipulative orientation. Narcissists are characterized by exhibitionism and vanity, and they see themselves as superior and entitled. To validate their grandiose self-image, narcissists purchase high-prestige products (i.e., luxurious, exclusive, flashy), show greater interest in the symbolic than utilitarian value of products, and distinguish themselves positively from others via their materialistic possessions. Our review lays the foundation for a novel methodological approach in which we explore how narcissism influences eye movement behavior during consumer decision-making. We conclude with a description of our experimental paradigm and report preliminary results. Our findings will provide insight into the mechanisms underlying narcissists’ conspicuous purchases. They will also likely have implications for theories of personality, consumer behavior, marketing, advertising, and visual cognition. PMID:24711797

[Sexual disorders in epilepsy. Results of a multidisciplinary evaluation].

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Silva, H C; Carvalho, M J; Jorge, C L; Cunha Neto, M B; Goes, P M; Yacubian, E M

1999-09-01

Eleven epileptic men who complained of epilepsy and sexual dysfunction were submitted to a multidisciplinary evaluation. Mean age was 27 years (20-34), mean epilepsy duration was 19 years (0.5-32) and the mean seizure frequency was two by week (0-7). Ten patients had partial seizures and one other had myoclonic epilepsy. Ten patients were treated with antiepileptic drugs (phenytoin--1, carbamazepine--8, clonazepam--3, clobazam--2, valproic acid--3, vigabatrin--1). As defined in the DSM III-R, the complaints were: erectile disorder (9), hypoactive sexual desire disorder (4), frotteurism (4), inhibited orgasm (3), premature ejaculation (3), fetishism (2), voyeurism (2), exhibitionism (2), pedophilia (1) and sexual aversion disorder (1). Two patients showed hypogonadotropic hypogonadism on endocrinologic screening. Urological evaluation disclosed organic erectile dysfunction in other two. One patient had a diagnosis of psychogenic sexual disorder. In six patients a conclusive etiologic diagnosis was not reached. This report shows the multifactorial nature of sexual disorder in epilepsy and underlies the need of a multidisciplinar evaluation.

Narcissism and consumer behaviour: a review and preliminary findings.

Science.gov (United States)

Cisek, Sylwia Z; Sedikides, Constantine; Hart, Claire M; Godwin, Hayward J; Benson, Valerie; Liversedge, Simon P

2014-01-01

We review the literature on the relation between narcissism and consumer behavior. Consumer behavior is sometimes guided by self-related motives (e.g., self-enhancement) rather than by rational economic considerations. Narcissism is a case in point. This personality trait reflects a self-centered, self-aggrandizing, dominant, and manipulative orientation. Narcissists are characterized by exhibitionism and vanity, and they see themselves as superior and entitled. To validate their grandiose self-image, narcissists purchase high-prestige products (i.e., luxurious, exclusive, flashy), show greater interest in the symbolic than utilitarian value of products, and distinguish themselves positively from others via their materialistic possessions. Our review lays the foundation for a novel methodological approach in which we explore how narcissism influences eye movement behavior during consumer decision-making. We conclude with a description of our experimental paradigm and report preliminary results. Our findings will provide insight into the mechanisms underlying narcissists' conspicuous purchases. They will also likely have implications for theories of personality, consumer behavior, marketing, advertising, and visual cognition.

Narcissism and Consumer Behaviour: A Review and Preliminary Findings

Directory of Open Access Journals (Sweden)

Sylwia Z Cisek

2014-03-01

Full Text Available We review the literature on the relation between narcissism and consumer behaviour. Consumer behaviour is sometimes guided by self-related motives (e.g., self-enhancement rather than by rational economic considerations. Narcissism is a case in point. This personality trait reflects a self-centred, self-aggrandizing, dominant, and manipulative orientation. Narcissists are characterised by exhibitionism and vanity, and they see themselves as superior and entitled. To validate their grandiose self-image, narcissists purchase high-prestige products (i.e., luxurious, exclusive, flashy, show greater interest in the symbolic than utilitarian value of products, and distinguish themselves positively from others via their materialistic possessions. Our review lays the foundation for a novel methodological approach in which we explore how narcissism influences eye movement behaviour during consumer decision-making. We conclude with a description of our experimental paradigm and report preliminary results. Our findings will provide insight into the mechanisms underlying narcissists’ conspicuous purchases. They will also likely have implications for theories of personality, consumer behaviour, marketing, advertising, and visual cognition.

Constructive processes in person cognition.

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Fiedler, K

1993-12-01

The notion of constructive memory processes is imported from research on eyewitness memory to the area of social cognition. Mere questioning about the applicability of personality attributes to a target person is shown to affect subsequent memory-based judgements of that person. These constructive influences are to be distinguished, conceptually, from the global notion of priming effects. In Expt 1, the target person was first described as an extravert; afterwards, subjects had to indicate whether either desirable aspects of extraversion (self-confidence) or undesirable aspects (exhibitionism) apply to the target or not. Mere questioning resulted in a congruent judgment bias towards the questioned attributes that did not generalize to a global halo effect. Experiment 2 replicated the basic finding and demonstrated that this phenomenon is independent of a generation effect (i.e. the memory advantage of self-generated inferences). These results are interpreted in terms of (a) a reframing of the categorical distribution representing the information about the target person in memory and (b) a regressive tendency to assume intermediate default values rather than extreme values for questioned attributes under uncertainty. Alternative explanations in terms of demand effects or a conformation bias cannot provide sufficient accounts. The relevance of constructive processes to understanding self-fulfilling prophecies and other phenomena in social interaction is discussed.

Inappropriate sexual behaviour in adolescents with autism spectrum disorder: what education is recommended and why.

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Beddows, Nicola; Brooks, Rachel

2016-08-01

Autism spectrum disorder (ASD) is a neurodevelopmental disorder impairing social skills and communication. Adolescents with ASD have sexual needs, but may not understand their physical and emotional development resulting in inappropriate sexual behaviour. The aim of this review is to describe the type of inappropriate behaviour that presents in these adolescents, explain why such behaviours occur, suggest what education is suitable and identify current gaps in research. The databases EMBASE, OVID MEDLINE and PSYCINFO were searched for relevant articles. In total, 5241 articles were found, with an additional 15 sources found via soft searches, of which 42 met inclusion criteria and were subsequently reviewed. Sexual behaviours that occur in these adolescents with ASD include hypermasturbation, public masturbation, inappropriate romantic gestures, inappropriate arousal and exhibitionism. Such behaviours are thought to be caused via a lack of understanding of normal puberty, the absence of appropriate sex education, the severity of their ASD and other associated problems. It is suggested that individualized, repetitive education should be started from an early age in an accessible form. Social skills development is also important before more technical aspects of sex education are taught. Despite being such a common problem for schools, institutions and families to manage, it is surprising how sparse literature is particularly regarding why inappropriate behaviour occurs and what education is effective. © 2015 Wiley Publishing Asia Pty Ltd.

[Rape by 2 assaillants and gang rape in Montreal].

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Lamontagne, Y; Boyer, R; Lamontagne, C; Giroux, J

1984-11-01

A survey was conducted in 230 cases of rape and rape attempts heard in the Judicial District of Montreal between January 1975 and May 1978. Data were compiled from the 30 assaults including two or more assaillants. Results show that in cases of rape committed by two men the aggressors are older than gang rapists, meet the victim mainly in her flat or in a bar, and rape her in her own home, in a car or a hotel. In these cases, voyeurism seems to be an important factor since, most of the time, rape is committed by only one of the two aggressors. On the other hand, gang rapists are younger, meet the victim in public places, on the street or when she is hitch-hiking and attack her in one of the aggressors' house, in public places or on the street. Exhibitionism seems more present in this group of rapists. For both groups the victims are mainly single, younger than the aggressors and have diverse occupations. Finally, regarding the legal outcome half of the subjects were liberated or acquitted in both groups. Rape committed by two men had never been studied or compared with gang rape up until now. Results of this survey show dynamic and demographic differences between these two groups of sexual delinquents.

Development of a Short Form of the Five-Factor Narcissism Inventory: the FFNI-SF.

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Sherman, Emily D; Miller, Joshua D; Few, Lauren R; Campbell, W Keith; Widiger, Thomas A; Crego, Cristina; Lynam, Donald R

2015-09-01

The Five-Factor Narcissism Inventory (FFNI; Glover, Miller, Lynam, Crego, & Widiger, 2012) is a 148-item self-report inventory of 15 traits designed to assess the basic elements of narcissism from the perspective of a 5-factor model. The FFNI assesses both vulnerable (i.e., cynicism/distrust, need for admiration, reactive anger, and shame) and grandiose (i.e., acclaim seeking, arrogance, authoritativeness, entitlement, exhibitionism, exploitativeness, grandiose fantasies, indifference, lack of empathy, manipulativeness, and thrill seeking) variants of narcissism. The present study reports the development of a short-form version of the FFNI in 4 diverse samples (i.e., 2 undergraduate samples, a sample recruited from MTurk, and a clinical community sample) using item response theory. The validity of the resultant 60-item short form was compared against the validity of the full scale in the 4 samples at both the subscale level and the level of the grandiose and vulnerable composites. Results indicated that the 15 subscales remain relatively reliable, possess a factor structure identical to the structure of the long-form scales, and manifest correlational profiles highly similar to those of the long-form scales in relation to a variety of criterion measures, including basic personality dimensions, other measures of grandiose and vulnerable narcissism, and indicators of externalizing and internalizing psychopathology. Grandiose and vulnerable composites also behave almost identically across the short- and long-form versions. It is concluded that the FFNI-Short Form (FFNI-SF) offers a well-articulated assessment of the basic traits comprising grandiose and vulnerable narcissism, particularly when assessment time is limited. (c) 2015 APA, all rights reserved.

Pope John Paul II apologizes for church's oppression of women.

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1995-01-01

In a 16-page letter which is widely viewed by women's groups as an effort to win support for the Vatican's position at the upcoming UN Conference on Women in Beijing, Pope John Paul II apologizes to women throughout the world for the church's historic complicity in their oppression. Although phrased in general terms, the letter contains language and ideas of a far more feminist tone than any previous statements or declarations made by the Pontiff. Calling for increased respect for women and sensitivity to their needs, the letter also claims that "there is an urgent need to achieve real equality in every area: equal pay for equal work, protection for working mothers, fairness in career advancements, equality of spouses with regard to family rights and recognition of everything that is part of the rights and duties of citizens in a democratic state." Recognizing women's significant achievements and sacrifices inside and outside of the home, the Pope expressed admiration for "those women of good will who have devoted their lives to defending the dignity of womanhood by fighting for their basic social, economic and political rights, demonstrating courageous initiative at a time when this was considered extremely inappropriate, the sign of a lack of femininity, a manifestation of exhibitionism, and even a sin." Although the letter heralds a new awareness in the Vatican of women's views, concerns and grievances, the Pope has not signaled any dramatic changes in official church policy: women's ordination, divorce, abortion and birth control are still considered beyond the pale of acceptability. full text

Sexual victimization of youth with a physical disability: an examination of prevalence rates, and risk and protective factors.

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Mueller-Johnson, Katrin; Eisner, Manuel P; Obsuth, Ingrid

2014-11-01

Children with disabilities have been shown to be at greater risk of victimization than those without. Although much of the research combines disability of any type into a single disability category, recent evidence suggests that not all types of disabilities are equally associated with victimization. To date, little knowledge exists about the victimization of youth with physical disabilities. This study used data from a national school-based survey of adolescents (n = 6,749, mean age = 15.41, SD = .66) in Switzerland to investigate sexual victimization (SV) among physically disabled youth. Two subtypes of SV were differentiated: contact SV, including penetration or touching/kissing, and non-contact SV, such as exhibitionism, verbal harassment, exposure to sexual acts, or cyber SV. A total of 360 (5.1%) youth self-identified as having a physical disability. Lifetime prevalence rates for contact SV were 25.95% for girls with a physical disability (odds ratio [OR] = 1.29 compared with able-bodied girls), 18.50% for boys with physical disability (OR = 2.78 compared with able-bodied boys), and 22.35% for the total sample with physical disability (OR = 1.74 compared with able-bodied youth). For non-contact SV, the lifetime prevalence was 48.11% for girls with a physical disability (OR = 1.44 compared with able-bodied girls), 31.76% for boys with physical disability (OR = 1.95 compared with able-bodied boys), and 40.28% for the total sample with physical disability (OR = 1.67 compared with able-bodied youth). After controlling for other risk factors, physical disability was a significant predictor of contact and non-contact SV for boys, but not for girls. © The Author(s) 2014.

Long-term follow-up of exhibitionists: psychological, phallometric, and offense characteristics.

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Firestone, Philip; Kingston, Drew A; Wexler, Audrey; Bradford, John M

2006-01-01

Exhibitionism has historically been viewed as more of a nuisance than a serious criminal justice matter. Research has demonstrated that the number of exhibitionists who are detected re-offending is a significant under-representation of the number who actually re-offend. The objective of this study was to extend a previous study conducted on exhibitionists, while attempting to solve the limitations described in that study. Two hundred eight exhibitionists were assessed at a university teaching hospital between 1983 and 1996. Archival data were derived from police and medical files. Results indicated that, over a mean follow-up period of 13.24 years, 23.6, 31.3, and 38.9 percent of exhibitionists were charged with or convicted of sexual, violent, or criminal offenses, respectively. Undoubtedly, this is an under-representation of the true rate, as we have no way of knowing how many exhibitionists re-offended and did not get caught. Nevertheless, in the present investigation, sexual recidivists compared with non-recidivists were less educated, scored higher on the Michigan Alcohol Screening Test (MAST), the Psychopathy Checklist, Revised (PCL-R), and the Pedophile Index. Violent recidivists were also less educated and scored higher on the MAST, PCL-R, and the Pedophile Index, and had accumulated a greater number of prior violent or criminal charges and/or convictions. Criminal recidivists were less educated; scored higher on the MAST, Buss-Durkee Hostility Inventory (BDHI), PCL-R, and Pedophile Index; and had accumulated a greater number of prior sexual, violent, and criminal offenses. Finally, the hands-on sexual recidivists accumulated a greater number of prior violent and criminal charges and or convictions than did the hands-off sexual recidivists.

Prevalence of non-contact and contact childhood sexual abuse: An Internet-based sample of men who have sex with men in China.

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Wenjian Xu

Full Text Available The prevalence of childhood sexual abuse (CSA is high among Western men who have sex with men (MSM, and CSA is associated with certain socio-demographic variables and with human immunodeficiency virus (HIV status. Little is known about CSA among Chinese MSM; therefore, we explored the prevalence and frequency of non-contact (e.g., sexual invitations, exhibitionism and contact (e.g., intercourse, genital contact forms of CSA in an Internet-based sample of MSM in China. We also examined the associations between the participants' socio-demographic characteristics and HIV status, and their histories of CSA.We surveyed MSM from 30 Chinese provinces in 2014-2015; 1,030 (mean age = 25.15 years, SD = 6.32 and 1,020 (mean age = 25.05 years, SD = 5.95 respondents were eligible for inclusion in the non-contact and contact CSA groups, respectively.Prevalence of non-contact and contact CSA was 36.2% and 29.8%, respectively; 20.4% and 15.0% had experienced non-contact and contact CSA ≥ 3 times, respectively. Most respondents were young adults, well educated, single, had never "come out," and self-identified as gay or bisexual men. Univariate analyses showed that respondents who had experienced contact CSA were more likely to be HIV-positive than those who had never experienced contact CSA. Multivariate analyses showed that non-contact CSA was associated with less education, being in a relationship with a woman or a man, and having "come out." Contact CSA was associated with less education, higher income, and being in a relationship with a man. Respondents who had experienced non-contact CSA ≥ 3 times were more likely to be less educated, "out," and to be in a relationship with a woman or a man. Respondents who had experienced contact CSA ≥ 3 times were more likely to be less educated and to be in a relationship with a man.It is necessary to pay closer attention to CSA among MSM and other sexual minorities in China.

Gender differences in narcissism: a meta-analytic review.

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Grijalva, Emily; Newman, Daniel A; Tay, Louis; Donnellan, M Brent; Harms, P D; Robins, Richard W; Yan, Taiyi

2015-03-01

Despite the widely held belief that men are more narcissistic than women, there has been no systematic review to establish the magnitude, variability across measures and settings, and stability over time of this gender difference. Drawing on the biosocial approach to social role theory, a meta-analysis performed for Study 1 found that men tended to be more narcissistic than women (d = .26; k = 355 studies; N = 470,846). This gender difference remained stable in U.S. college student cohorts over time (from 1990 to 2013) and across different age groups. Study 1 also investigated gender differences in three facets of the Narcissistic Personality Inventory (NPI) to reveal that the narcissism gender difference is driven by the Exploitative/Entitlement facet (d = .29; k = 44 studies; N = 44,108) and Leadership/Authority facet (d = .20; k = 40 studies; N = 44,739); whereas the gender difference in Grandiose/Exhibitionism (d = .04; k = 39 studies; N = 42,460) was much smaller. We further investigated a less-studied form of narcissism called vulnerable narcissism-which is marked by low self-esteem, neuroticism, and introversion-to find that (in contrast to the more commonly studied form of narcissism found in the DSM and the NPI) men and women did not differ on vulnerable narcissism (d = -.04; k = 42 studies; N = 46,735). Study 2 used item response theory to rule out the possibility that measurement bias accounts for observed gender differences in the three facets of the NPI (N = 19,001). Results revealed that observed gender differences were not explained by measurement bias and thus can be interpreted as true sex differences. Discussion focuses on the implications for the biosocial construction model of gender differences, for the etiology of narcissism, for clinical applications, and for the role of narcissism in helping to explain gender differences in leadership and aggressive behavior. Readers are warned against overapplying small effect sizes to perpetuate gender

Validity aspects of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, narcissistic personality disorder construct.

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Karterud, Sigmund; Øien, Maria; Pedersen, Geir

2011-01-01

The Diagnostic and Statistical Manual of Mental Disorders (DSM), Fourth Edition, narcissistic personality disorder (NPD) construct has been criticized for being too narrowly defined, for example, by focusing on overt grandiosity at the expense of exhibitionism and narcissistic vulnerability and thus covering only parts of the domain of narcissism. The purpose of this study was to elucidate several validity aspects of the NPD construct. The material consisted of data from 2277 patients (80% of whom had a personality disorder [PD]) who were admitted to units connected to The Norwegian Network of Psychotherapeutic Day Hospitals. The Axis II diagnoses were assessed by Structured Clinical Interview for DSM, Fourth Edition, Axis II Personality Disorders. The frequency of NPD was very low (0.8%). Male patients were overrepresented both on a diagnostic level and on criteria levels. The NPD category was positively associated with other cluster B disorders and negatively associated with avoidant PD. The criteria "demands excessive admiration" and "fantasies of unlimited success" correlated almost as highly with the histrionic PD category and loaded primarily on a histrionic factor. The dominant NPD factor also included the antisocial criterion of "showing no regret having injured others." The major part of the patients' personality pathology could be attributed to other PD criteria. The results challenge the notion of NPD as a distinct diagnostic category. Rather, narcissism should be conceived as personality dimensions pertinent to the whole range of PDs. The results support the views put forward by Russ et al (Refining the construct of narcissistic personality disorder: diagnostic criteria and subtypes. Am J Psychiatry 2008;11:1473-1481) that what clinicians conceive as narcissism consists of several subtypes (dimensions). Our data support the existence of a grandiose/malignant type and an exhibitionistic type. Unfortunately, there was no measure of hypersensitivity. The

A controlled study of Tourette syndrome. IV. Obsessions, compulsions, and schizoid behaviors.

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Comings, D E; Comings, B G

1987-01-01

To determine the frequency of obsessive, compulsive, and schizoid behaviors in Tourette syndrome (TS), we prospectively questioned 246 patients with TS, 17 with attention-deficit disorder (ADD), 15 with ADD due to a TS gene, and 47 random controls. The comparative frequency of obsessive, compulsive, and repetitive behaviors--such as obsessive unpleasant thoughts, obsessive silly thoughts, echolalia, palilalia, touching things excessively, touching things a specific number of times, touching others excessively, sexual touching, biting or hurting oneself, head banging, rocking, mimicking others, counting things, and occasional or frequent public exhibitionism--were significantly more common in TS patients than in controls. The frequency of each of these was much higher for grade 3 (severe) TS. Most of these behaviors also occurred significantly more often in individuals with ADD or in individuals with ADD secondary to TS (ADD 2(0) TS). When these features were combined into an obsessive-compulsive score, 45.4% of TS patients had a score of 4-15, whereas 8.5% of controls had a score of 4 or 5. These results indicate that obsessive-compulsive behaviors are an integral part of the expression of the TS gene and can be inherited as an autosomal dominant trait. Schizoid symptoms, such as thinking that people were watching them or plotting against them, were significantly more common in TS patients than in controls. Auditory hallucinations of hearing voices were present in 14.6% of TS patients, compared with 2.1% of controls (P = .02). These symptoms were absent in ADD patients but present in ADD 2(0) TS patients. These voices were often blamed for telling them to do bad things and were frequently identified with the devil. None of the controls had a total schizoid behavior score greater than 3, whereas 10.9% of the TS patients had scores of 4-10 (P = .02). This frequency increased to 20.6% in the grade 3 TS patients. These quantitative results confirm our clinical

Transtornos parafílicos em pacientes com transtorno obsessivo-compulsivo: série de casos Paraphilic disorders among patients with obsessive-compulsive disorder: case series

Directory of Open Access Journals (Sweden)

Manuela C. Borges

2007-01-01

Full Text Available Com o intuito de elucidar a relação entre transtornos do controle de impulsos (TCI e transtorno obsessivo-compulsivo (TOC, faz-se mister estudar subgrupos mais clinicamente homogêneos de transtornos impulsivos. Por meio do relato de quatro casos de pacientes com TOC e diferentes tipos de transtornos parafílicos (fetichismo transvético, sadismo, ginandromorfofilia e exibicionismo, são discutidos os conceitos de compulsividade, impulsividade e a relação temporal entre ambos. O estudo dos casos aqui descritos mostra que (1 pacientes com TOC e transtornos parafílicos tendem a desenvolver o TOC primeiro, (2 diante de desejos, fantasias ou atos sexuais parafílicos, pacientes com TOC podem lançar mão de comportamentos tipicamente compulsivos, (3 pacientes com TOC e obsessões sexuais egodistônicas podem desenvolver desejos, fantasias ou atos sexuais parafílicos de conteúdo semelhante ao das obsessões, (4 em um mesmo paciente, TOC e parafilias podem apresentar cursos independentes, e (5 pacientes com TOC e parafilias podem não apresentar obsessões sexuais. O sofrimento de pacientes com TOC e parafilias justifica a investigação continuada de tais condições no intuito de elucidar os mecanismos que subjazem esta associação e de criar estratégias que aumentem a adesão ao tratamento.In order to elucidate the relationship between impulse control disorders and obsessive-compulsive disorder (OCD, it is essential to study more clinically homogenous subgroups of patients with impulsive disorders. Using four cases of patients with OCD and comorbid paraphilias (transvestic fetishism, sadism, gynandromorphophilia, and exhibitionism as reference-points, we discuss the concepts of compulsivity, impulsivity, and the temporal relationship between them. The case studies here described suggest that (1 patients with OCD and comorbid paraphilias tend to develop OCD first, (2 once developing paraphilic fantasies, desires, or behaviors, patients with

Pharmacology of sexually compulsive behavior.

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Codispoti, Victoria L

2008-12-01

In a meta-analysis on controlled outcomes evaluations of 22,000 sex offenders, Losel and Schmucker found 80 comparisons between treatment and control groups. The recidivism rate averaged 19% in treated groups, and 27% in controls. Most other reviews reported a lower rate of sexual recidivism in treated sexual offenders. Of 2039 citations in this study (including literature in five languages), 60 studies held independent comparisons. Problematic issues included the control groups; various hormonal, surgical, cognitive behavioral, and psychotherapeutic treatments; and sample sizes. In the 80 studies compared after the year 2000, 32% were reported after 2000, 45% originated in the United States, 45% were reported in journals, and 36% were unpublished. Treatment characteristics showed a significant lack of pharmacologic treatment (7.5%), whereas use cognitive and classical behavioral therapy was 64%. In 68% of the studies, no information was available on the integrity of the treatment implementation; 36% of the treatment settings were outpatient only, 31% were prison settings, and 12% were mixed settings (prison, hospital, and outpatient). Integrating research interpretations is complicated by the heterogeneity of sex offenders, with only 56% being adult men and 17.5% adolescents. Offense types reported included 74% child molestation, 48% incest, and 30% exhibitionism. Pedophilia was not singled out. Follow-up periods varied from 12 months to greater than 84 months. The definition of recidivism ran the gamut from arrest (24%), conviction (30%), charges (19%), and no indication (16%). Results were difficult to interpret because of the methodological problems with this type of study. Overall, a positive outcome was noted with sex offender treatment. Cognitive-behavioral and hormonal treatment were the most promising. Voluntary treatment led to a slightly better outcome than mandatory participation. When accounting for a low base rate of sexual recidivism, the reduction

[Studying dysfunctional personality trends among sex offenders].

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Perrot, M; Bénony, H; Chahraoui, K; Juif, C

2014-10-01

A review of the literature reveals a consensus on the high prevalence of personality disorders among sexual offenders. Studies show that there is no unique personality profile for sex offenders. In France, little research has been conducted on this population with standardized assessment tools. The objective of the present study is to identify the distribution of personality disorders among sexual offenders using a new French questionnaire, i.e. the TD12. In view of the literature, we postulate that this tool will identify the diversity of personality disorders observed by various authors, but with a higher proportion of cluster B disorders. This study was conducted among 56 men, including 28 sex offenders aged from 21 to 70 years old, and a control group of 28 men without psychiatric disorders. The sex offenders in this study are men convicted or charged with sex offenses of various kinds: exhibitionism, the recording, distribution and possession of pornography depicting minors, aggravated corruption of a minor, sexual assault of a minor, or rape of a minor. They were examined using an inventory of dysfunctional trends recently developed by Rolland and Pichot with the aim of assessing dysfunctional personality styles. The TD-12 questionnaire is composed of 140 items describing thoughts, feelings and behaviors. It is based on the diagnostic criteria of Axis II of DSM IV-TR and consists of twelve scales that match the personality disorders described in this diagnostic manual (ten officially recognized disorders and two additional disorders). From a categorical viewpoint, results indicate rigid dysfunctional trends with regard to avoidant personality disorder in sex offenders compared to the control group (Chi(2)=9.16; P=0.005). However, there were no significant differences between the two groups regarding the number of rigid dysfunctional trends. Potentially controllable dysfunctional personality trends are identified for the dependent personality (Chi(2

Pharmacological interventions for those who have sexually offended or are at risk of offending.

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Khan, Omer; Ferriter, Michael; Huband, Nick; Powney, Melanie J; Dennis, Jane A; Duggan, Conor

2015-02-18

the five community-based studies ranged from 3% to 54% and results were usually analysed on a per protocol basis).Participant characteristics in the seven studies were heterogeneous, but the vast majority had convictions for sexual offences, ranging from exhibitionism to rape and child molestation.Six studies examined the effectiveness of three testosterone-suppressing drugs: cyproterone acetate (CPA), ethinyl oestradiol (EO), and medroxyprogesterone acetate (MPA); a seventh evaluated two antipsychotics (benperidol and chlorpromazine). Five studies were placebo-controlled; in two, MPA was administered as an adjunctive treatment to a psychological therapy (assertiveness training or imaginal desensitisation). Meta-analysis was not possible due to heterogeneity of interventions, comparators, study designs, and other issues. The quality of the evidence overall was poor. In addition to methodological issues, much evidence was indirect. recividism. Two studies reported recidivism rates formally. One trial of intramuscular MPA plus imaginal desensitisation (ID) found no reports of recividism at two-year follow-up for the intervention group (n = 10 versus one relapse within the group treated by ID alone). A three-armed trial of oral MPA, alone or in combination with psychological treatment, reported a 20% rate of recidivism amongst those in the combined treatment arm (n = 15) and 50% of those in the psychological treatment only group (n = 12). Notably, all those in the 'oral MPA only' arm of this study (n = 5) dropped out immediately, despite treatment being court mandated.Two studies did not report recidivism rates as they both took place in one secure psychiatric facility from which no participant was discharged during the study, whilst another three studies did not appear directly to measure recividism but rather abnormal sexual activity alone. The included studies report a variety of secondary outcomes. Results suggest that the frequency of self reported deviant sexual