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Relationships among personal, indoor, and outdoor fine and coarse particle concentrations for individuals with COPD.

This study characterizes the personal, indoor, and outdoor PM2.5, PM10, and PM2.5-10 exposures of 18 individuals with chronic obstructive pulmonary disease (COPD) living in Boston, MA. Monitoring was performed for each participant for six consecutive days in the winters of 1996 or 1997 and for six to twelve days in the summer of 1996. On each day, 12-h personal, indoor, and outdoor samples of PM2.5 and PM10 were collected simultaneously. Home characteristic information and time-activity patterns were also obtained. Personal exposures were higher than corresponding indoor and outdoor concentrations for all particle measures and for all seasons, except for winter indoor PM2.5-10 levels, which were higher than personal and outdoor levels. Higher personal exposures may be due to the proximity of the individuals to particle sources, such as cooking and cleaning. Indoor concentrations were associated with both outdoor concentrations and personal exposures (as determined by individual least square regression analyses), with associations strongest for PM2.5. Indoor PM2.5 concentrations were significantly associated with outdoor and personal levels for 12 and 15 of the 17 individuals, respectively. Both the strength and magnitude of the associations varied by individual. Also, personal PM2.5, but not PM2.5-10, exposures were associated with outdoor levels, with 10 of the 17 subjects having significant associations. The strength of the personal-outdoor association for PM2.5 was strongly related to that for indoor and outdoor levels, suggesting that home characteristics and indoor particulate sources were key determinants of the personal-outdoor association for PM2.5. Air exchange rates were found to be important determinants of both indoor and personal levels. Again, substantial interpersonal variability in the personal-outdoor relationship was found, as personal exposures varied by as much as 200% for a given outdoor level.

Activities of Daily Living↗

Partner relationships, functioning, mood and global quality of life in persons with spinal cord injury and traumatic brain injury.

The aim of this study was to assess and compare spinal cord injured (SCI) and traumatic brain injured (TBI) persons and people from the general population concerning partner relationships, functioning, mood and global quality of life. One hundred and sixty seven SCI persons, 92 TBI persons and 264 controls participated in the study. The median age was: SCI persons 33 years (range 19 to 79 years), TBI persons 40 years (range 20 to 70 years), and controls 31 years (range 19 to 79 years). Age at injury ranged among SCI persons from 14 to 76 years (Md 28 years), and among TBI persons from 16 to 56 years (Md 32 years). Half of the SCI group (51%), 58% of the TBI group and 59% of the controls had a stable partner relationship at the time of the investigation. Many of these SCI and TBI relationships (38% and 55% respectively) were established after injury. Both SCI and TBI persons showed significantly more depressive feelings compared with the controls. Perceived quality of life (global QL rating) was significantly lower in the SCI group compared with the controls, whereas the ratings of TBI persons and controls did not differ significantly. SCI and TBI persons did not differ significantly in level of education, perceived quality of life or distress. In all three groups, global quality-of-life ratings were significantly lower among single persons compared to those with a partner relationship. It was concluded that both SCI and TBI appear to affect overall quality of life and mental well-being negatively. The number of partner relationships contracted after injury among both SCI and TBI persons indicates, however, that the injury is not a major barrier to establishing close partner relationships. Being in good spirits, that is, lack of depressive feelings has a profound impact on the perception of a high quality of life in all three groups. For the SCI and TBI persons, a high level of physical and social independence were further positive determinants of a perceived high quality of life.

Activities of Daily Living↗

The personalized cueing method: from the laboratory to the clinic.

PURPOSE: The personalized cueing method is a novel procedure for treating naming deficits of persons with aphasia that is relatively unfamiliar to most speech-language pathologists. The goal of this article is to introduce the personalized cueing method to clinicians so that it might be expanded and improved upon. It is also hoped that this article will promote further research in the treatment of naming deficits of clients with aphasia. METHOD: This clinical focus article (a) describes the origins of the personalized cueing method, the steps involved in creating personalized cues, and training and assessment procedures used with the personalized cueing method; (b) summarizes the published research supporting the use of the personalized cueing method; and (c) highlights some of the clinical advantages of this novel naming treatment for clients and clinicians. RESULTS: Research with the personalized cueing method indicates that durability (long-term naming accuracy) for items trained with the personalized cueing method exceeds that for items trained with phonological cueing and other methods. It further shows that as the stimuli used to train naming in the personalized cueing experiments have become more realistic, durability of personalized cueing has increased. CONCLUSION: Personalized cueing is a parsimonious approach for treatment of naming deficits of persons with aphasia that has shown positive treatment effects in 8-12 training sessions.

Aphasia↗

Exposure of chronic obstructive pulmonary disease patients to particulate matter: relationships between personal and ambient air concentrations.

Mot time-series studies of particulate air pollution and acute health outcomes assess exposure of the study population using fixed-site outdoor measurements. To address the issue of exposure misclassification, we evaluate the relationship between ambient particle concentrations and personal exposures of a population expected to be at risk of particle health effects. Sampling was conducted within the Vancouver metropolitan area during April-September 1998. Sixteen subjects (non-smoking, ages 54-86) with physician-diagnosed chronic obstructive pulmonary disease (COPD) wore personal PM2.5 monitors for seven 24-hr periods, randomly spaced approximately 1.5 weeks apart. Time-activity logs and dwelling characteristics data were also obtained for each subject. Daily 24-hr ambient PM10 and PM2.5 concentrations were measured at five fixed sites spaced throughout the study region. SO4(2-), which is found almost exclusively in the fine particle fraction and which does not have major indoor sources, was measured in all PM2.5 samples as an indicator of accumulation mode particulate matter of ambient origin. The mean personal and ambient PM2.5 concentrations were 18 micrograms/m3 and 11 micrograms/m3, respectively. In analyses relating personal and ambient measurements, ambient concentrations were expressed either as an average of the values obtained from five ambient monitoring sites for each day of personal sampling, or as the concentration obtained at the ambient site closest to each subject's home. The mean personal to ambient concentration ratio of all samples was 1.75 (range = 0.24 to 10.60) for PM2.5, and 0.75 (range = 0.09 to 1.42) for SO4(2-). Regression analyses were conducted for each subject separately and on pooled data. The median correlation (Pearson's r) between personal and average ambient PM2.5 concentrations was 0.48 (range = -0.68 to 0.83). Using SO4(2-) as the exposure metric, the median r between personal and average ambient concentrations was 0.96 (range = 0.66 to 1.0). Use of the closest ambient site did not improve the median correlation of the group for either PM2.5 or SO4(2-). All pooled analyses resulted in lower correlation coefficients than the median correlation coefficient of individual regressions. Personal SO4(2-) was more highly correlated with all ambient measures than PM2.5. Inclusion of time-activity and dwelling characteristics data did not result in a useful predictive regression model for PM2.5 personal exposure, but improved the model fit from simply regressing against ambient concentration (R2 = 0.27). The model for SO4(2-) was predictive (R2 = 0.82), as personal exposures were largely explained by ambient levels. These results indicate a relatively low correlation between personal exposure and ambient PM2.5 that is not improved by assigning exposure to the closest ambient monitor. The correlation between personal exposure and ambient concentration is high, however, when using SO4(2-), an indicator of accumulation mode particulate matter of ambient origin.

Aged↗

Underutilization of aspirin, beta blockers, angiotensin-converting enzyme inhibitors, and lipid-lowering drugs and overutilization of calcium channel blockers in older persons with coronary artery disease in an academic nursing home.

BACKGROUND: We report the prevalence of use of aspirin, beta blockers, angiotensin-converting enzyme (ACE) inhibitors or angiotensin II type 1 receptor blockers, statins, and calcium channel blockers in older persons with coronary artery disease (CAD) in an academic nursing home. METHODS: We investigated the prevalence of use of aspirin, beta blockers, ACE inhibitors or angiotensin II type 1 receptor blockers, lipid-lowering drugs, and calcium channel blockers in older persons with a mean age of 77 +/- 9 years, in an academic nursing home with documented CAD and no contraindications to the use of aspirin, beta blockers, ACE inhibitors or angiotensin II type 1 receptor blockers, and lipid-lowering drugs. RESULTS: CAD was documented in 77 of 255 persons (30%). Of 77 persons with CAD, 48 persons (62%) were treated with aspirin, 45 persons (58%) with ACE inhibitors or angiotensin II type 1 receptor blockers, 44 persons (57%) with beta blockers, 21 persons (27%) with calcium channel blockers, and 16 persons (21%) with statins. Of the 61 persons with CAD not treated with statins, serum low-density lipoprotein (LDL) cholesterol was measured in only 22 persons (36%) and was increased in 14 of the 22 persons (64%). CONCLUSIONS: These data show underutilization of aspirin, beta blockers, ACE inhibitors, lipid-lowering drugs, and measurement of serum LDL cholesterol and overutilization of calcium channel blockers in older persons with CAD in an academic nursing home.

Academic Medical Centers↗

Epidemiology of AIDS in incarcerated persons in the United States, 1994-1996.

OBJECTIVE: To compare demographic, behavioral, and geographic characteristics of incarcerated persons with AIDS and those of all persons with AIDS reported from January 1994 through December 1996. DESIGN: Population-based surveillance. SETTING: Medical records of persons for whom AIDS diagnosis was made in hospitals, clinics, and other settings (e.g., prisons) in the United States. PATIENTS: Adults (13 years or older) with AIDS reported from January 1994 through December 1996. RESULTS: Of the 220000 AIDS cases in adults, 4% were reported in incarcerated persons. Compared with all persons with AIDS, a higher proportion were male (89% versus 82%), black (58% versus 39%), younger at time of diagnosis (35 versus 37 years), had injected drugs (61% versus 27%), and were reported on the basis of the 1993 immunologic criteria (71% versus 50%). Fewer cases in incarcerated persons were diagnosed at death (3% versus 10%). The South (38%) and the Northeast (37%) United States accounted for the largest proportion of incarcerated persons. The 1996 AIDS rate for incarcerated persons (199 per 100000) was six times the national rate of 31 per 100000. Among persons incarcerated at time of diagnosis, rates for women were higher than for men (287 versus 185 per 100000) and higher for blacks and Hispanics than for whites (253, 313, and 100 per 100000, respectively). By state of report, Connecticut had the highest rate among incarcerated persons (1348 per 100000). CONCLUSION: These data illustrate differences in demographic, behavioral, and geographic characteristics of incarcerated persons compared with all persons with AIDS. However, they reflect only the minimum numbers of incarcerated persons with AIDS in the United States. Our results highlight the need for state health departments to work with correctional systems to ensure accurate and timely reporting of AIDS cases and to develop HIV prevention, education, and treatment both in prison and on release into the community.

Acquired Immunodeficiency Syndrome↗

Emotional distress and activities of daily living functioning in persons with multiple sclerosis.

BACKGROUND: Emotional distress is higher in persons with multiple sclerosis (MS) than in other chronic illnesses. Not known is whether personal attributes of the person with MS and/or the presence of social support will function as mediating and/or moderating variables between emotional distress and adaptation to the illness. OBJECTIVES: Determine if personal attributes and social support function as mediating and/or moderating variables between emotional distress and ADL functioning in persons with MS. METHODS: Secondary analyses of data obtained from 686 persons with MS through self-report measures of emotional distress, personal attributes, social support, and ADL functioning was conducted. Separate mediation and moderation models were tested using stepwise and hierarchical multiple regression. Demographic variables of education, age, and length of MS illness, were controlled in all analyses. RESULTS: Personal attributes and social support functioned as mediator variables between emotional distress and ADL functioning. Additionally, personal attributes and not social support functioned as a moderator. Significant main effects were shown for social support and emotional distress in the moderator model. CONCLUSION: Personal attributes and social support mediated the effects of emotional distress by decreasing its impact on ADL functioning. Personal attributes, as a moderator variable, demonstrated that higher levels were associated with low levels of emotional stress and moderate or lower levels of personal attributes were associated with increased emotional distress suggesting that personal attributes may intervene between emotional distress and ADL functioning by attenuating or preventing a stress appraisal response.

Activities of Daily Living↗

Management of the older person with ventricular arrhythmias.

OBJECTIVE: To review the prognosis and management of ventricular arrhythmias (VA) in persons with and without heart disease, with emphasis on older adults. DATA SOURCES: A computer-assisted search of the English language literature (MEDLINE database) followed by a manual search of the bibliographies of pertinent articles. STUDY SELECTION: Studies on the prognosis and management of VA in persons with and without heart disease were screened for review. Studies in older persons and recent studies were emphasized. DATA EXTRACTION: Pertinent data were extracted from the reviewed articles. Emphasis was placed on studies involving older persons. Relevant articles were reviewed in depth. DATA SYNTHESIS: Available data on the prognosis and management of VA in persons with and without heart disease, with emphasis on studies in older persons, were summarized. CONCLUSIONS: Ventricular arrhythmias in older persons without heart disease should not be treated with antiarrhythmic drugs, nor should Class I antiarrhythmic drugs be used to treat VA in older persons with heart disease. Beta-blockers should be used to treat complex VA in older persons with ischemic or nonischemic heart disease without contraindications to beta-blockers. Amiodarone should be reserved for life-threatening ventricular tachyarrhythmias in older persons who cannot tolerate or who do not respond to beta-blockers. Angiotensin-converting enzyme inhibitors should be used to treat older persons with heart failure, an anterior myocardial infarction, or a left ventricular ejection fraction < or = 40%. If older persons have life-threatening recurrent ventricular tachycardia (VT) or ventricular fibrillation (VF) resistant to antiarrhythmic drugs, invasive intervention should be performed. The automatic implantable cardioverter-defibrillator is recommended in older persons who have medically refractory sustained VT or VF.

Adrenergic beta-Antagonists↗

Validating the Draw-A-Man Test as a personal neglect test.

OBJECTIVES: The purpose of this study was to determine the reliability and validity of a Draw-A-Man Test in measuring personal neglect in patients with right brain stroke. METHOD: Draw-A-Man Test was administered to 51 persons with right cerebrovascular accident (CVA) and 110 age-matched persons without brain insult. A categorical classification was developed based on the man drawn in the test. Participants who showed homogeneous bilateral representation of body parts were considered to not have personal neglect, whereas those who showed unilateral body parts were considered to have personal neglect. The completed tests were used to blindly categorize the persons with and without personal neglect according to the above definition by two raters for calculating interrater reliability. The Klein-Bell ADL (Activities of Daily Living) Scale was also administered to the participants with right CVA to validate the Draw-A-Man Test. RESULTS: This dichotomy--bilateral representation versus unilateral representation--showed a high percentage of agreement between two raters. Rater A classified all 110 "normal" participants as being without personal neglect and classified 13 of the 51 participants with stroke as having personal neglect. Participants demonstrating personal neglect showed significantly poorer ADL performance than did those without personal neglect. ADL performance was also found to be significantly related to somatosensation, motor status of the impaired limbs, and muscle strength of the sound limbs. However, even after controlling the effect of these variables by partial correlation, personal neglect was still highly related to ADL performance. CONCLUSION: The Draw-A-Man Test is a reliable and valid tool for discriminating clients with personal neglect from those without.

Activities of Daily Living↗

Adiponectin concentrations as a criterion of metabolic control in persons with type 2 diabetes mellitus?

UNLABELLED: Adiponectin (ADP) is an adipocytokin with many antiatherogenic properties; its decreased level is associated with numerous atherogenic diseases and syndromes (e.g. diabetes mellitus (DM), dyslipidemia, endothelial dysfunction, hypertension, and obesity). Decreased ADP values in blood may be an independent risk factor of atherosclerotic (ATS) complications. AIM OF THE STUDY: 1) Do persons with type 2 diabetes have lower ADP values than individuals without DM but with a high risk of ATS complications? 2) Do ADP values differ between persons with well controlled and persons with uncontrolled type 2 diabetes? We examined 109 patients of the Metabolic Center of Hospital Sternberk. Out of them, 58 had type 2 diabetes, others were individuals with variously expressed risk factors of early atherosclerosis (obesity, hypertension, age, family history, smoking, dyslipidemia, etc.). In all persons under this study the following parameters were determined in peripheral venous blood: adiponectin, resistin, leptin, ObRe, cholesterol, HDL-cholesterol, triacylglycerols, glucose, HbA1c, creatinine, urea, ALT, AST, CRP, homocysteine, thrombocyte aggregation after CPG induction. The whole group was divided according to the presence of type 2DM into two subgroups; persons with diabetes were divided into the well controlled and uncontrolled subgroups. All data obtained were processed statistically using the software SPSS for Windows and Medcalc. The adiponectin/BMI index correlated negatively with HbA1c value (correlation coefficient -0.37, p = 0.00053), triacylglycerols (-0.4, p = 0.000001), P-glucose (-0.3, p = 0.0017), uricemia (-0.35, p = 0.0007) and positively with HDL-cholesterol value (0.6, p=0.00001). Women had higher adiponectin values than men. Persons with hypertension and with diabetes mellitus, individuals with atherogenic lipotype or persons with inflammation signs had lower values than individuals without these diseases and syndromes. Persons with wellcontrolled diabetes mellitus had higher values than persons with uncontrolled diabetes (medians of the adiponectin/BMI index 9.7 vs. 6.7, p < 0.01). Persons with type 2 diabetes mellitus have lower ADP values than persons with a high ATS risk without diabetes mellitus. Persons with wellcontrolled diabetes mellitus (DM) and with satisfactory compensation have significantly higher ADP levels (independently of other metabolic parameters of DM control). ADP may be a new marker of metabolic control in persons with a high risk of atherosclerotic complications.

Adiponectin↗

Relationships of Indoor, Outdoor, and Personal Air (RIOPA). Part I. Collection methods and descriptive analyses.

This study on the relationships of indoor, outdoor, and personal air (RIOPA) was undertaken to collect data for use in evaluating the contribution of outdoor sources of air toxics and particulate matter (PM) to personal exposure. The study was not designed to obtain a population-based sample, but rather to provide matched indoor, outdoor, and personal concentrations in homes that varied in their proximity to outdoor pollution sources and had a wide range of air exchange rates (AERs). This design allowed examination of relations among indoor, outdoor, and personal concentrations of air toxics and PM across a wide range of environmental conditions; the resulting data set obtained for a wide range of environmental pollutants and AERs can be used to evaluate exposure models. Approximately 100 households with residents who do not smoke participated in each of three cities in distinct locations expected to have different climates and housing characteristics: Elizabeth, New Jersey; Houston, Texas; and Los Angeles County, California. Questionnaires were administered to characterize homes, neighborhoods, and personal activities that might affect exposures. The concentrations of a suite of volatile organic compounds (VOCs) and carbonyl compounds, as well as the fraction of airborne particulate matter with a mass median aerodynamic diameter < or = 2.5 microm (PM2.5), were measured during continuous 48-hour sessions in which indoor, outdoor, and personal air samples were collected simultaneously. During the same 48-hour period, the AER (exchanges/hr; x hr(-1)) was determined in each home, and carbonyl compounds were measured inside vehicle cabins driven by a subset of the participants. In most of the homes, measurements were made twice, during two different seasons, to obtain a wide distribution of AERs. This report presents in detail the data collection methods, quality control measures, and initial analyses of data distributions and relations among indoor, outdoor, and personal concentrations. The results show that indoor sources dominated personal and indoor air concentrations of many measured VOCs and carbonyl compounds. For several measured species, personal concentrations were higher than either indoor or outdoor concentrations, indicating the presence of some sources closely related to personal activities. For some species there were no significant indoor sources in the majority of the homes; thus indoor concentrations were mainly determined by outdoor concentrations in these homes. The range of distributions of air concentrations for the measured VOCs, formaldehyde and acetaldehyde, PM2.5, and AERs were generally consistent with values reported previously in the literature. Thus associations derived from or models based on this data set that may link the influence of outdoor sources with indoor air concentrations of air toxics and PM2.5 can be relevant to other urban settings. The simultaneous measurements of indoor concentrations, outdoor concentrations, AERs, and room volumes allowed the use of a mass balance model, under the steady-state approximation, to mechanistically examine the relative contributions of indoor and outdoor sources to measured indoor concentrations on a home-by-home basis. Estimated indoor source strengths for VOCs and carbonyl compounds varied widely from home to home, consistent with the indoor-outdoor concentration patterns, as shown in scatter plots. The indoor source estimations agreed with published values for PM2.5 and with the general understanding of sources of VOCs and carbonyl compounds. The source strengths reported here, derived from hundreds of homes, are an important contribution to the literature on exposure to air toxics. For the first time for many compounds, these estimates present a cohesive set of measurements across a range of air toxics in paired indoor, outdoor, and personal samples along with AER and questionnaire results that can be used for future analyses of indoor air quality. The estimation of outdoor contributions to measured indoor concentrations provides insights about the relative importance of indoor and outdoor sources in determining indoor concentrations, the main determinant of personal exposure for most of the measured compounds. In this report simple statistical tests mainly of the pooled data were used to analyze differences by sampling site, emission source type, season, home type, and home age. Paired adult-child personal concentrations within the same home were also compared using the pooled data set. These analyses generated some intriguing results that warrant more in-depth investigation in the future.

Air Movements↗

Personality patterns in patients with myotonic dystrophy.

BACKGROUND: Myotonic dystrophy (DM) is a multisystemic disease. The central nervous system is affected by cognitive, affective, and personality disturbances. A characteristic behavior was noted from the first clinical descriptions, but no definitive conclusions have been drawn despite extensive debate. As DM is a genetic disease of well-defined abnormality, it may be a good model for understanding the relative contributions of nature and nurture in the building of personality traits. OBJECTIVE: To investigate the possibility that there is a personality pattern that is characteristic of patients with DM. SUBJECTS AND METHODS: The personalities of 15 adult (age range, 20-53 years) patients with DM with no, or minimal, muscle weakness were studied by means of the International Personality Disorder Examination. The results were compared with those from 14 matched healthy subjects (age range, 20-54 years) and 12 patients (age range, 22-50 years) with a mild form of facioscapulohumeral dystrophy. SETTING: The Department of Neuromuscular Diseases, Hôpital de la Salpêtrière, Paris, France. RESULTS: Patients with DM exhibited a homogeneous personality profile, with statistically significant differences (P<.005) for avoidant, obsessive-compulsive, passive-aggressive, and schizotypic traits. In both groups of controls, the personality profiles were extremely heterogeneous. Personality disorders (avoidant personality) were found in 4 of 15 patients with DM. CONCLUSIONS: The findings of this study suggest that the personality pattern of patients with DM is related to their disease. Their personality disorders are not attributable to their adjustment to a disabling condition. By contrast, among the patients with DM, the high incidence of avoidant personality, a phenotype poorly represented in the general population, supports the idea that it is the expression of a primary phenomenon related to a genetic mutation.

Adult↗

Association between a promoter dopamine D2 receptor gene variant and the personality trait detachment.

BACKGROUND: Personality traits have shown considerable heritable components. Striatal dopamine D(2) receptor density, as determined by positron-emission tomography, has been associated with detached personality, as assessed by the Karolinska Scales of Personality. A putative functional promoter polymorphism in the dopamine D(2) receptor gene (DRD2), -141C ins/del, has been associated with dopamine D(2) receptor density. METHODS: In this study healthy subjects (n = 235) who filled in at least one of several personality questionnaires (Karolinska Scales of Personality, Swedish Universities Scales of Personality, Health-relevant Five-factor Personality Inventory, and Temperament and Character Inventory) were analyzed with regard to the DRD2 -141C ins/del variant. RESULTS: There was an association (p =.001) between the DRD2 -141C ins/del variant and Karolinska Scales of Personality Detachment scale, indicating higher scores in subjects with the -141C del variant. There were also associations between the DRD2 -141C ins/del variant and a number of Karolinska Scales of Personality and Swedish Universities Scales of Personality Neuroticism-related scales, but of these only Swedish Universities Scales of Personality Lack of Assertiveness scale (p =.001) survived correction for multiple testing. CONCLUSIONS: These results add further support for the involvement of dopamine D(2) receptor in certain personality traits. The results should be treated with caution until replicated.

Genetic Predisposition to Disease↗

Descriptive and longitudinal observations on the relationship of borderline personality disorder and bipolar disorder.

OBJECTIVE: The purpose of this study was to test whether borderline personality disorder is a variant of bipolar disorder by examining the rates of co-occurrence in both disorders, the effects of co-occurrence on a longitudinal course, and whether the presence of either disorder confers the risk for new onsets of the other. METHOD: A prospective repeated-measures design with reliable independent diagnostic measures and 4 years of follow-up was used to assess 196 patients with borderline personality disorder and 433 patients with other personality disorders. RESULTS: Patients with borderline personality disorder had a significantly higher co-occurrence of bipolar disorder (19.4%) than did patients with other personality disorders. However, this co-occurrence did not appear to affect the subsequent course of borderline personality disorder. Although only 8.2% of the borderline personality disorder patients developed new onsets of bipolar disorder, this rate was higher than in patients with other personality disorders. Patients with other personality disorders with co-occurring bipolar disorder generally had more new onsets of borderline personality disorder (25%) than did patients with other personality disorders without co-occurring bipolar disorder (10%). CONCLUSIONS: A modest association between borderline personality disorder and bipolar disorder is reported.

Adolescent↗

Personality characteristics of alcoholic fathers and their sons.

Recovering alcoholic fathers with a positive family history of alcoholism and their 10-15 year-old sons were assessed on a variety of personality measures and compared to a matched group of nonalcoholic fathers with a negative family history of alcoholism, and their sons. Assessment instruments for the sons included the Personality Inventory for Children, High School Personality Questionnaire, Junior Eysenck Personality Inventory and the Tridimensional Personality Questionnaire. Comparable questionnaires were administered to the fathers: the MMPI, 16 Personality Factor Questionnaire, Eysenck Personality Inventory and the Tridimensional Personality Questionnaire. No psychopathology or extreme personality variants were observed in either fathers' or sons' groups. However, MANOVAS and linear discriminant functions revealed significant differences on several personality measures between fathers' and sons' groups. Compared to sons of nonalcoholics, sons of alcoholics were relatively more compulsive, insecure and fearful while being more subdued and detached. The recovering alcoholics were more impulsive and regimented than the nonalcoholics. An index resulting from the combination of the best personality discriminators was significantly correlated in father-son pairs. In addition, this index was significantly correlated with key neurocognitive variables from our previous study which assessed the same father-son pairs. This atypical CNS profile, encompassing altered electrophysiology, neuropsychological performance and personality traits, may be useful in identifying those at increased risk for developing alcoholism.

Adult↗

[Effect of group psychotherapy on changes in symptoms and personality traits in patients with anxiety syndromes].

Psychotherapy remains the most efficient form of treatment in neurotic and personality disorders. It is a process whereby the therapist can influence and change the patient's personality. As a result, patients are able to better understand their experiences and behavior and are given a chance to be freed from symptoms. The goal of the present study was to establish the relationship between group psychotherapy and specific symptom clusters, and to follow changes in the personality structure of patients of both genders diagnosed according to ICD-10 classification. The Symptoms Questionnaire and the Personality Factor test were used to determine the severity of symptoms and study personality traits. The study group consisted of 115 patients (76 women and 39 men) with neurotic or personality disorders, participating in group therapy at the Day Care Unit of the Department of Psychiatry, Pomeranian Academy of Medicine in Szczecin between 1992 and 1998. Four groups were formed depending on the diagnosis according to ICD-10 classification: anxiety disorders--F41; somatic disorders--F45; neurotic disorders--F48; and personality disorders--F60 (Table 1). Treatment started and ended with a CV Questionnaire, Symptoms Questionnaire and Personality Factor test. Group psychotherapy was in the open form and the duration of treatment was 12 weeks with 2 sessions per day. In order to detect any improvement in mental health and symptoms, patients were given the Symptoms Questionnaire on a weekly basis. Statistics were done with the SPSS software package. It was found that the global intensity of symptoms before treatment was highest in patients with somatic form of the disorder. In this group after therapy, the intensity of symptoms was lowest, probably because of conversion of primary to secondary anxiety. A considerable decrease in the intensity of symptoms may also be explained by stronger motivation of these patients to benefit from therapy because of their severe symptoms. A link between the clinical diagnosis according to ICD-10 and some symptoms reported by the patients was noted. Thus, the Symptoms Questionnaire could be a useful tool precisely revealing specific symptoms in some disorders. No statistically significant differences on the Symptoms Questionnaire scale based on ICD-10, nor any differences in personality traits were found. The personality traits were different for men and women before and after therapy. As for hysterical symptoms, improvement was greater in women. After psychotherapy, the structure of personality traits improved in both sexes (Fig. 1). An essential alleviation of symptoms was found at the beginning and at the end of treatment (Table 2). The main conclusions are: 1. Group psychotherapy is an efficient method of treatment for patients who suffer from anxiety-related disorders. 2. The Symptoms Questionnaire and Personality Factor test were very useful for assessing the results of psychotherapy. 3. Alleviation of symptoms during treatment differed between men and women in 3 out of 13 symptom clusters and no significant differences between disorders according to ICD-10 were found. Consequently, these criteria are of little value for preliminary evaluation of therapeutic success. 4. Alleviation of symptoms was observed at the beginning and end of treatment. Symptom severity remained constant in the middle part of treatment.

Adult↗

Predicting personality pathology among adult patients with substance use disorders: effects of childhood maltreatment.

The purpose of this study was to examine predictive relationships between types of childhood maltreatment and personality disorders in a substance-abusing population. Three hundred thirty-nine drug- or alcohol-dependent patients completed a reliable and valid retrospective measure of childhood trauma, the CTQ, and a self-report inventory that assesses the entire range of DSM-III-R personality disorders, the PDQ-R. As a preliminary step, factor analyses were used to group personality disorders into the three DSM-III-R Axis II clusters (Clusters A, B, and C), although some diagnostic subclusters were also found. Structural equation modeling analyses revealed several significant paths between types of maltreatment and personality disorder clusters (and subclusters). Physical abuse and physical neglect were related to a subcluster of "psychopathic" personality disorders consisting of childhood and adult antisocial personality traits and sadistic traits. Emotional abuse emerged as a broad risk factor for personality disorders in Clusters A, B, and C. Emotional neglect was related to the traits of schizoid personality disorder, which formed its own subcluster. Finally, sexual abuse, which had been expected to predict borderline personality disorder traits, was unrelated to any personality disorder cluster. These findings support the view that child maltreatment contributes to the high prevalence of co-morbid personality disorders in addicted populations.

Adult↗

Latent structure of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition personality disorder criteria.

AIMS: This study investigated the internal construct validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) personality disorders and explored alternative models to characterize the personality disorder traits. The relationship between the obtained personality disorder dimensions and measures of functioning and disability was examined. METHODS: The subjects in the study were 742 community-residing individuals who participated in the Hopkins Epidemiology of Personality Disorders Study. The presence of DSM-IV personality disorder traits was assessed by psychologists using the International Personality Disorder Examination (IPDE). Confirmatory factor analysis was performed on all the IPDE criteria for each of the 10 personality disorders using the Mplus program. Exploratory factor analysis of all personality disorder traits was completed using the same program. Factor scores were correlated with subjects' GAF ratings and number of missed days from work for physical and psychological reasons. RESULTS: A single underlying factor was found for the IPDE item criteria of avoidant and dependent personality disorder, with less evidence for the other 8 personality disorders. Five factors were retained as the dimensional accounting for the personality disorder criteria. These factors were named compulsive, neurotic avoidant, aloof, impulsive callous, and egocentric. Of the five factors, 4 were associated with evidence of diminished functioning. CONCLUSIONS: The IPDE pathological personality traits did not empirically cluster according to the current DSM-IV axis II diagnostic system but instead defined 5 relatively independent PD symptom dimensions that were related to functional impairments.

Adult↗