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Biomedical subjects

R M Bagby

Publications and source records attributed to R M Bagby.

At least 37 records · Page 2Linked to original sources
PubMed1999

Diagnostic discriminability of dysthymia and depressive personality disorder.

The Depressive Personality Disorder (DPD) is currently being considered for inclusion in future editions of DSM. However, there is little empirical research on DPD as currently defined in DSM-IV, including whether this disorder is sufficiently distinct from Dysthymic Disorder (Dysthymia). The goal of this study was to explore the relationship between DPD and Dysthymia with a sample of depressed outpatients. Scales were developed for the diagnostic criteria for both DPD and Dysthymia. These scales were then analyzed using cluster and factor analysis. Retroactive diagnostic assignment for these two disorders was also made using these scales. It was hypothesized that if DPD is a viable diagnostic category, then the DPD traits and Dysthymia symptoms would fall into different clusters, produce separate factors, and the comorbidity would be small. Two clusters and two factors, each with a close correspondence to DPD and Dysthymia, were statistically extracted from combined symptom and trait scales. However, 95% of those cases identified as meeting diagnostic criteria for DPD also met criteria for Dysthymia. Despite the ability to distinguish statistically DPD traits from Dysthymia symptoms, there was a high degree of comorbidity, compromising the clinical utility of DPD. The results do suggest, however, that DPD might be best conceptualized as a subcategory of Dysthymia.

Adult↗
PubMed1998

Negative attributional style in seasonal and nonseasonal depression.

OBJECTIVE: There is a substantial relationship between dysfunctional cognitions and the clinical course of major depression. This study examined whether this association extends to patients with seasonal affective disorder. METHOD: A revised version of the Attributional Style Questionnaire was used to assess negative attributional style and predict response to treatment in a group of depressed outpatients, 26 with seasonal depression and 30 with nonseasonal, unipolar major depression. RESULTS: Pretreatment scores on negative attributional style did not differ between the patients with seasonal affective disorder and those with nonseasonal depression. Negative attributional style predicted poor response to pharmacotherapy in the nonseasonal depression group but did not predict response to light therapy in the group with seasonal affective disorder. CONCLUSIONS: Dysfunctional cognitions may play a lesser role in seasonal affective disorder than in nonseasonal depression.

Adult↗
PubMed1998

Self-report ratings and informants' ratings of personalities of depressed outpatients.

OBJECTIVE: This study sought to determine whether personality traits of depressed patients could be assessed similarly by informants and self-reports of the patients themselves. METHOD: Forty-six depressed outpatients completed the self-report (first-person) version of the Revised NEO Personality Inventory and nominated informants who knew them well to complete the third-person version of that instrument. RESULTS: Agreement between the self-ratings and informants' ratings on the five factors of the inventory--neuroticism, extraversion, openness-to-experience, agreeableness, and conscientiousness--was high. The only significant difference between the self-ratings and informants' ratings was on the extraversion scale, where the patients rated themselves as significantly more introverted than did the informants. CONCLUSIONS: Informants' ratings of personality are similar to self-report ratings of depressed patients. Depressed mood may not influence the self-report of personality traits.

Adult↗
PubMed1998

Confirmatory factor analysis of the revised Personal Style Inventory.

The revised Personal Style Inventory (PSI) was developed to measure the sociotropy and autonomy personality dimensions; both of these dimensions are thought to confer specific vulnerabilities to the onset, maintenance, and reoccurrence of depression. Confirmatory factor analysis was used to test the theoretical structure that informed the construction of the PSI. Using a large sample of nonclinical participants (n = 869) and a sample of outpatients with major depression (n = 101), both the items and the subscales of the PSI decomposed into factor structures that were, overall, fair to good representations of the theoretical model. Modifications were needed at the subscale level to achieve an adequate fit for the nonclinical and clinical samples, which provide implications for both the measurement and theory of the PSI and the sociotropy and autonomy domains.

Adult↗
PubMed1998

Utility of the Deceptive-Subtle items in the detection of malingering.

The aim of this study was to assess the capacity of a recently developed set of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) subtle items--the Deceptive Subtle scale (DS)--to detect fake-bad responding on the MMPI-2, relative to the capacity of the F scale and the sum of obvious items (Ob) and sum of subtle items (Su) scales. The MMPI-2 was administered to a sample of research participants asked to fake-bad (n=74), and compared to psychiatric outpatients (n=100) and nonclinical participants (n=100) asked to respond honestly. Although the DS scale proved to be a better predictor of fake-bad response style than Su,and comparable to that of Ob, its predictive capacity was substantially less than that of F. Future research is needed to explore the potentially unique contribution of both DS and Ob to assess different strategies of faking-bad.

Adolescent↗
PubMed1997

Relationship between the five-factor model of personality and unipolar, bipolar and schizophrenic patients.

The purpose of this study was to examine personality differences among three different Axis I disorders-recovered patients with unipolar depression (n = 62), euthymic patients with bipolar disorder (n = 34), and patients with schizophrenia in the residual phase of their illness (n = 41) using the five-factor model of personality (FFM). The dimensions of the FFM-Neuroticism (N), Extraversion (E), Openness (O), Agreeableness (A), and Conscientiousness (C)-were measured with composite scores derived from the NEO Personality Inventory (NEO PI) and the Revised NEO Personality Inventory (NEO PI-R). While no group differences emerged on N or C, the bipolar patients scored significantly higher on the Positive Emotion facet (subscale) of E than the unipolar patients. The schizophrenic patients scored lower on the Feelings, Values and Actions facets of O than did the unipolar and bipolar patients. The unipolar patients scored higher on A than the schizophrenic patients.

Adult↗
PubMed1997

Personality and symptom profiles of the angry hostile depressed patient.

Fava, Rosenbaum, McCarthy, Pava, Steingard and Bless (1991) have recently proposed the existence of a subtype of depressed patients who experience anger attacks. The aim of this study was to assess if depressed patients categorized as high angry hostile have symptoms and personality profiles distinct from depressed patients categorized as low angry hostile. From a sample of 125 depressed outpatients, 26 patients were classified as high angry hostile and 25 patients as low angry hostile. The symptom profiles of these tow groups were remarkably similar, with the high angry hostile patients exhibiting more interpersonal sensitivity. The high angry hostile patients were rated as less interpersonally agreeable and less conscientious than low angry hostile patients. These results provide only partial support for the angry hostile subtype of depression.

Adult↗
PubMed1997

Differential pharmacological treatment response in high angry hostile and low angry hostile depressed patients: a retrospective analysis.

Fava et al., Am. J. Psychiatry 150 (1993)1158-1163, have recently proposed the existence of a sub-type of depressed patients who experience anger attacks. These investigators hypothesized that patients who experience anger attacks will respond better to a specific selective serotonin reuptake inhibitor (SSRI) medication than will depressed patients who do not experience anger attacks. Using a non-randomized, archival treatment methodology, 158 patients were classified as either high angry hostile (n = 83) or low angry hostile (n = 75). These patients had been treated with either a primarily noradrenergic reuptake inhibitor (desipramine) a SSRI (sertraline or paroxetine), or the combined serotonin and norepinephrine reuptake inhibitor (SNRI), venlafaxine. A 2 (high angry hostile/low angry hostile) x 3 (medication type) analysis of variance (ANOVA) was non-significant, indicating no differential treatment effects.

1-Naphthylamine↗
PubMed1997

Evaluating stability and change in personality and depression.

Critics have argued that personality factors believed to represent a vulnerability to depression are not stable and are therefore state dependent. However, conclusions regarding the stability of personality and the relation between personality and depression have been drawn (a) without differentiating relative stability among individual differences from absolute stability of change scores and (b) without explicitly modeling change in personality as a function of change in depression. The relation between neuroticism and depression was examined in a sample of depressed outpatients (N = 71) receiving a 5-week trial of pharmacotherapy. Measures of neuroticism and extraversion demonstrated both relative stability and absolute change, and changes in neuroticism and extraversion scores were modestly or not at all accounted for by changes in depression scores. Claims that personality scores are not stable and are state dependent must be reconsidered.

Adult↗
PubMed1997

Boundary violations and personality traits among psychiatrists.

OBJECTIVE: To demonstrate that sexual abuse of patients by psychiatrists can be due to a variety of contributors, which may include therapists' psychopathic and narcissistic personality styles. METHOD: Data from a prospective cohort of residents training in psychiatry were examined to evaluate the personality traits of 2 psychiatrists subsequently convicted of boundary violations. RESULTS: The 2 psychiatrists who lost their licenses were identifiable at the beginning of their residency training as individuals with significant character pathology. CONCLUSIONS: For some psychiatrists, repetitive sexual abuse of patients represents one aspect of an ongoing pattern of exploitative relationships. The professional and ethical implications of these findings as they relate to early identification for those at risk are considered.

Cohort Studies↗
PubMed1997

Boundary violations and departments of psychiatry.

OBJECTIVE: To explore a number of issues related to boundary violations in psychiatry, including the relationship between the individual physician and his or her patient and broader issues related to various dilemmas arising in academic departments of psychiatry. METHOD: Several potentially troublesome scenarios are presented and discussed in the contexts of 1) the doctor-patient relationship, 2) sexual boundary violations, and 3) nonsexual forms of exploitation, such as finances, confidentiality, dual relationships, and relationships with industry. CONCLUSIONS: A number of examples of boundary problems involving psychiatrists have been explored, and although some of these behaviours are clearly forbidden and harmful, others are less clear and require careful consideration if the profession is to arrive at a thoughtful consensus.

Adult↗
PubMed1997

Detecting feigned depression and schizophrenia on the MMPI-2.

Increasingly, investigations evaluating the effectiveness of the MMPI-2 in the assessment of malingering employ methodologies whereby research participants are asked to feigned specific disorders rather than just to "fake bad." Yet there is little research addressing the issue of whether different validity scales and indicators work differently in the detection of different feigned disorders. In this study the comparative effectiveness of a number of validity scales and indicators on the MMPI-2 to assess feigned depression and feigned schizophrenia were evaluated. Overall, the validity scales and indicators were better at detecting feigned schizophrenia than they were in detecting feigned depression, attributable, most likely, to closer familiarity with depressive experiences. The validity scales F, Fb, and F(p) best distinguish patients with schizophrenia from participants feigning schizophrenia, and F and Fb best distinguish patients with depression from participants feigning depression.

Adult↗
PubMed1996

Bipolar disorder, unipolar depression and the Five-Factor Model of personality.

We examined differences between personality characteristics of euthymic bipolar disorder patients (BD) (n = 34) and recovered unipolar depressed patients (UD) (n = 74) using the taxonomy of the Five-Factor Model of personality (FFM) as measured by composite scales derived from the NEO Personality Inventory (NEO PI) and the revised NEO PI (NEO PI-R). Euthymic BD patients scored significantly higher on the Openness (O) dimension and the Positive Emotions facet of the E dimension than did recovered UD patients. For O, euthymic BD patients scored higher on the Feelings facet. These results suggest not only that euthymic BD patients are more likely to experience positive affects than recovered UD patients, but also that euthymic BD patients are more receptive to their positive and negative feelings than are recovered UD patients.

Adult↗
PubMed1996

Seasonal and non-seasonal depression and the five-factor model of personality.

The purpose of this study was to compare the personality characteristics of patients with non-psychotic, major depression, seasonal subtype (SAD) to patients with non-psychotic, major depression, without seasonality (non-SAD). The patients were consecutive referrals to a university-affiliated mood disorders outpatient clinic. The personality characteristics were assessed using the five-factor model of personality (FFM) as measured by the revised NEO Personality Inventory (NEO PI-R). Patients were assessed during the acute depressive episode. Controlling for severity of depression, differences were found on only one of the five dimensions, with the SAD patients (n = 43) scoring significantly higher on the Openness dimension than non-SAD patients (n = 57). Based on these results we infer SAD patients may represent a psychologically distinct subgroup of depressed patients-more imaginative, more emotionally sensitive and likely to entertain unconventional ideas than non-SAD patients. This personality constellation may explain why individuals with SAD are more sensitive to and may amplify the mild dysphoria typically associated with winter months.

Depressive Disorder↗
PubMed1996

A longitudinal study of alexithymia and psychological distress in inflammatory bowel disease.

A group of 104 patients with inflammatory bowel disease (IBD) was followed longitudinally for 6 months. While anxiety and depression scores were influenced over time by changes in the level of disease activity, there was no significant change in alexithymia scores. The findings support the contention that alexithymia is a stable personality characteristic in some IBD patients, in contrast to anxiety and depression which are state phenomena influenced by the level of disease activity.

Adult↗
PubMed1996

Relationships between alexithymia and psychological characteristics associated with eating disorders.

This study examines the relationships between alexithymia and psychological characteristics and behaviors that are commonly associated with eating disorders. The 20-item Toronto Alexithymia Scale (TAS-20) and the Eating Disorder Inventory (EDI) were administered to a group of 48 female patients with anorexia nervosa, a matched comparison group of 30 normal women, and an unmatched comparison group of 116 male and 118 female university students. In the anorexic and male student groups, the TAS-20 correlated significantly and positively with the EDI subscales, Ineffectiveness, Interpersonal Distrust, Interoceptive Awareness, and Maturity Fears. The TAS-20 correlated significantly only with Interpersonal Distrust in the matched comparison group, and only with Ineffectiveness and Interpersonal Distrust in the female student group. The results suggest that alexithymia is related to several psychological traits that are characteristic of patients with eating disorders and thought to play a role in the development of the disorders but is unrelated to attitudes and behaviors concerning abnormal eating and body weight and shape.

Adult↗
PubMed1995

A comparison of Tridimensional Personality Questionnaire dimensions in bipolar disorder and unipolar depression.

The harm avoidance (HA) personality dimension has been hypothesized to be a vulnerability factor for unipolar depression (UD) but not for bipolar disorder (BD). The reported difference on HA scores between these diagnostic groups may have been compromised by the assessment of BD patients who had not fully recovered. To test the diagnostic specificity of elevated HA scores and to elucidate whether assumptions about differences between patients with UD or BD might be attributed to the lingering effects of mood state, the Tridimensional Personality Questionnaire (TPQ) was administered to recovered patients with either BD or UD and a nonpatient comparison group. Both patient groups scored higher on the HA dimension than the nonpatient comparison group, but the patient groups did not differ from one another on this dimension. Moreover, novelty seeking (NS) scores were elevated in subjects with BD compared with both UD patients and nonpatient subjects. These results suggest that high HA scores may be associated with a mood disorder diagnosis, whereas high NS scores may be associated with the BD subtype.

Adult↗