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PurposeThe aim of this paper is to assess highly toxic leaders and dysfunctional organizations as presented via management consulting and executive coaching assignments.Design/methodology/approachThe paper employs an action research approach via two participant observer case studies incorporating theDSM IV‐TR: Diagnostic and Statistical Manual of Mental Disorders.FindingsThe paper finds that the nexus of dysfunctional organizational systems may be located in "pre‐existing" leadership pathologies.Research limitations/implicationsFirst, additional research will be needed to confirm and extend the findings of individual pathologies in leaders to dysfunctional organizational systems; second, a closer look is necessary at the applicability of theDSM IV‐TRto pathologies at the organizational level; third, due to the action research, case study approach utilized, there is somewhat limited generalizability; fourth, there are limitations re: the applicability ofDSM IV‐TRas an assessment tool for management researchers due to the necessity of training in clinical psychology.Practical implicationsThe importance of distinguishing personality disorders in leaders from toxic behaviors falling within a range of "normal pathology," and the ability to assess individual leadership pathology within organizational systems via the clinically trained usage of theDSM IV‐TR; providing clinical assessment tools for reducing the number of misdiagnoses of leadership pathology in the workplace; encouraging collaboration between management and psychology researchers and practitioners.Originality/valueThis paper fills a gap in the toxic organizations research by identifying personality disorders in leaders and providing an action research agenda for incorporating theDSM IV‐TRas a means of extending the repertoire of assessment tools;

Every lawyer either has heard of or has been involved in a divorce case that initially seemed manageable and resolvable only to find that it develops into a nightmarish drama. The parties involved in such cases are often those who have a personality disorder. A personality disorder is a clinical term used to describe people who are "locked in" for many years, with certain exaggerated personality traits that interfere with many aspects of their daily functioning. It is exceptionally difficult to achieve client control when working with a client with a personality disorder. This article will describe nine personality disorders, how to identify them, and how to work with them.

The present study investigated multivariate associations between attachment styles and personality disorders (PDs)—and the mediating role of trust—in a sample of child molesters ( n = 84) and a matched control group from the general community ( n = 80). Among child molesters, canonical correlation analysis revealed that two variates resembling avoidant and anxious attachment dimensions were associated with PD traits. Attachment avoidance was related to schizoid, schizotypal, and avoidant PDs, with a marginal contribution of antisocial PD. Attachment anxiety was related to borderline and histrionic PDs, with a marginal contribution of obsessive-compulsive PD. Paranoid and dependent PDs contributed to both variates. In the control group, a more general association between attachment insecurity and PDs emerged. Finally, mistrust significantly explained the associations between attachment and PDs in both samples. Future studies should examine whether treatment for PDs in child molesters could benefit from a focus on attachment and trust.

ZusammenfassungStudien zeigen einen robusten Zusammenhang zwischen psychischen Störungen und Sexualdelinquenz. Im Vergleich zur Allgemeinbevölkerung sind bei Sexualstraftätern sowohl paraphile Störungen als auch Persönlichkeitsstörungen überrepräsentiert. Auch zeigen persönlichkeits- und paraphil gestörte Sexualstraftäter gegenüber Sexualdelinquenten ohne solche Diagnosen neben anderen psychischen Störungen häufiger psychosoziale Auffälligkeiten, Schwierigkeiten im Bereich der Behandlung und ungünstigere Legalprognosen. Es lassen sich zudem deliktspezifische Unterschiede beobachten: Vergewaltiger und Sexualmörder weisen diagnostisch eher Persönlichkeitsstörungen aus dem Cluster B und einen sexuellen Sadismus auf, während Täter mit Kindern als Opfern vermehrt im Cluster C zu finden sind und mit einer Pädophilie diagnostiziert werden. Diskutiert werden unterschiedliche Hypothesen zu den Verbindungen zwischen Sexualdelinquenz und Persönlichkeits- sowie paraphilen Störungen. Diagnostisch relevante Normabweichungen in Sexualität und Persönlichkeit bieten zwar keine monokausale Erklärung für die Entstehung und Aufrechterhaltung von Sexualdelinquenz, sind jedoch oftmals elementar für ein umfassendes Deliktverständnis und bedürfen in der Planung und Umsetzung der Behandlung von Sexualstraftätern besonderer Aufmerksamkeit.

Purpose: Assess the new alternative Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) model for personality disorders (PDs) as it is seen by its creators and critics. Method: Follow the DSM revision process by monitoring the American Psychiatric Association website and the publication of pertinent journal articles. Results: The DSM-5 PD Work Group's proposal was not included in the main diagnostic section of the new DSM, but it was published in the section devoted to emerging models. The alternative DSM-5 PD constructs are radically different from those found in DSM, fourth edition, text revision. Discussion: There are some positive conceptual changes in the new model, but reliability and validity are not generally improved. However, social workers may be able to benefit from the use of the personality trait domains/facets of the alternative model.

Personality disorders (PD) play an important role in clinical psychiatry. The typologies of personality disorders (PDs) found in different classification systems, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD), are quite congruent. There are many methodological problems with reliability and validity of the diagnosis of PD. However, having a typology seems to be very helpful. Recent psychological autopsy studies reported that about one third of suicide victims met the criteria for a PD. Antisocial PD, borderline PD, narcissistic PD, and depressive PD in particular were often clinically associated with suicidal behavior.

Die qualitative Inhaltsanalyse ist eine Methode zur systematischen Beschreibung qualitativer Daten mithilfe von regelbasierten Verfahren und menschlicher Interpretation. Unser Ziel in diesem Beitrag ist es, die methodischen Aspekte des Verfahrens im Bereich der klinischen Psychologie zu reflektieren. Im Folgenden gehen wir zunächst auf die Umsetzung qualitativer Inhaltsanalyse in der klinischen Psychologie ein und beschreiben die Vielfalt der in diesem Bereich anzutreffenden inhaltsanalytisch orientierten Studien. Besonderes Augenmerk richten wir dabei auf Kategoriensysteme. Anschließend stellen wir Probleme und Herausforderungen bei der Durchführung qualitativ-inhaltsanalytischer Studien in einem spezifisch klinischen Kontext dar, nämlich die erklärende Diagnose von Persönlichkeitsstörungen. Ausgehend von den Herausforderungen (Erkennen klinisch relevanter Informationen, Erklärung des Pathomechanismus, Zugang zu unbewussten inneren Prozessen, Rolle relationaler Informationen bei der Bewertung) zeigen wir mögliche Lösungen für die Phase der Datenaufbereitung und -analyse auf. Dazu gehören der ausgewogene Rekurs auf psychologische Theorien und die Identifizierung von Mustern in Daten und Kategorien zu Erklärungszwecken, die Analyse aktueller Prozesse zur Beurteilung der Dynamik des psychologischen Lebens (intrapsychisch und interpersonal) und der relationale Kontext, der aus der Reflexion von Kodierung als menschlicher Prozess gewonnen wird.

Migrants and ethnic minorities are at risk of being under- and overdiagnosed with personality disorders (PDs). A culturally informed approach to the classification of PDs guides clinicians in incorporating migration processes and cultural factors, to arrive at a reliable and valid assessment of personality pathology. In this article, we provide a tentative framework to highlight specific interactions between personality disorders, migration processes, and cultural factors. It is argued that migration processes can merely resemble personality pathology, activate certain (latent) vulnerabilities, and aggravate pre-existing personality pathology. We propose that these migration processes can include manifestations of grief about the loss of pre-migratory psychosocial and economic resources, and the struggle to attain psychosocial and economic resources in the host culture. Moreover, several cultural dimensions are outlined that can either resemble or mask personality pathology. The term "culturally masked personality disorder" is coined, to delineate clinical cases in which cultural factors are overused or misused to rationalize behavioral patterns that are consistently inflexible, distressing, or harmful to the individual and/or significant others, lead to significant impairment, and exceed the relevant cultural norms. Additionally, the role of historical trauma is addressed in the context of potential overdiagnosis of personality disorders in Indigenous persons, and the implications of misdiagnosis in migrants, ethnic minorities, and Indigenous populations are elaborated. Finally, clinical implications are discussed, outlining various diagnostic steps, including an assessment of temperament/character, developmental history, systemic/family dynamics, migration processes, cultural dimensions, and possible historical trauma.

We describe the nature and prevalence of personality disorders (PD) in the older adult population and the unique presentation of personality disorder in late life. Building upon awareness of the reinforcement patterns articulated in Segal, Coolidge, and Rosowsky's (2006) model of PD, we discuss the challenges frequently encountered by geriatric care managers in caring for older clients with PD, the support needs of their families, and effective elements of professional care management suitable for this population. Using case examples, we present strategies for assisting clients having strained interpersonal relationships or difficulties navigating service systems, and we offer suggestions for forging successful client relationships.