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Personality and tonic cardiovascular, neuroendocrine, and immune parameters.

Although there is now abundant evidence that certain personality features constitute risk factors for negative health outcomes, personality measures have received little attention to date in the behavioral immunology literature. The present study assessed the relationship between major dimensions of personality and tonic cardiovascular, neuroendocrine, and immunologic parameters in 276 healthy adults. Participants who scored low in agreeableness tended to have higher levels of systolic blood pressure, diastolic blood pressure, and epinephrine. Low levels of extraversion were associated with higher blood pressure, epinephrine, norepinephrine, and natural killer cell cytotoxicity. Neuroticism was generally unrelated to physiologic outcomes. Personality was not associated with leukocyte subset counts. The magnitude of relationships between personality and physiology was modest, with personality measures accounting for 1 to 7% of the variance in selected physiological parameters. Health practices did not mediate associations between personality and physiologic outcomes. However, a substantial proportion of the relationship between extraversion and natural killer cell cytotoxicity was accounted for by their common association with epinephrine and to a lesser extent norepinephrine. These findings are consistent with the notion that personality contributes to basal physiology and provide a foundation for further research on the relationship between personality and natural killer cell cytotoxicity.

Adolescent↗

Axis I disorders and personality disorders as risk factors for suicide.

There is a lack of psychological autopsy studies assessing the influence of axis I disorders on axis II disorders as risk factors for suicide. Therefore, we investigated the association between personality disorders, axis I disorders, and suicide. Psychiatric disorders were evaluated by a semi-structured interview including the Structured Clinical Interview for DSM-IV Axis I (SCID-I) and Personality Disorders (SCID-II) in 163 completed suicides (mean age 49.6 +/- 19.3 years; 64.4% men) and by personal interview in 396 population-based control persons (mean age 51.6 +/- 17.0 years; 55.8% men). In both genders, suicides significantly more often had personality disorders of all clusters than controls, also after adjustment for axis I disorders (p < 0.001, each). In addition, alcohol-related disorders, major depression, and co-occurrence of personality disorders of more than one cluster (men: OR = 16.13; women: OR = 20.43) remained independent predictors for suicide in both genders, "pure" cluster B personality disorders only in women and "pure" cluster C personality disorders only in men. In both genders, co-occurrence of personality disorders of more than one cluster contributed to risk of completed suicide after control for axis I psychiatric disorders and has to be considered as an independent risk factor for suicide.

Adult↗

Depression and personality disorder.

Research into the relationship between depression and personality disorder is compromised by a number of methodologic factors, including differing concepts of personality disorder, the validity of a personality disorder diagnosis, the effect of mood on diagnosis, and the overlap between some personality disorder symptoms and mood symptoms. Personality pathology is common in patients with personality disorder. Reasons for this include a "scar" effect of chronic low mood on attitudes and behaviors, as well as possible risk factors via certain personality traits. The negative effect of comorbid personality disorder on treatment outcome in depressed patients may be less than previously believed. Possible reasons include treatment bias in non-controlled trials and the increasing use of selective serotonin reuptake inhibitors rather than tricyclic antidepressants. Many personality traits and disorders may be part of the psychopathology of depression and share a common origin.

Affect↗

Personality profiles associated with smokeless tobacco use patterns.

The purpose of this study was to examine the personality characteristics of male dippers and chewers of smokeless tobacco. The study objective was to determine any differences in personality characteristics between dippers and chewers of smokeless tobacco and nonusers. A survey at a southeastern university provided a sample of 289 males, of which 55 (19%) were smokeless tobacco users. Each subject was administered a demographic data sheet and Cattell's Sixteen Personality Factor Questionnaire (16 PF). Smokeless tobacco users were categorized as snuff dippers or tobacco chewers, and comparisons of personality characteristics were made between persons who exclusively dipped, persons who exclusively chewed, persons who dipped and chewed, and persons who did neither. The results of the study indicated that smokeless tobacco use is primarily a White male habit; very few Blacks or other racial groups consumed smokeless tobacco among this population. Significant (p less than 0.05) personality differences between snuff dippers and tobacco chewers were noted. Snuff dippers were more socially outgoing, enthusiastic, imaginative and group dependent than chewers. Chewers were found to be more uncompromising, critical in outlook and practical and less easily influenced by others than dippers.

Adolescent↗

The role of context in remembering familar persons: insights from semantic dementia.

Semantic dementia (SD) is a progressive condition characterized by an insidious and gradual breakdown in semantic knowledge. Patients suffering from this condition gradually lose their knowledge of objects and their attributes, concepts, famous persons, and public events. In contrast, these patients maintain a striking preservation of autobiographical memory. The aim of the present study was to examine in a patient suffering from SD the role of context in the ability to recall knowledge of familiar persons. In an experiment, patient J.M. was asked to name and identify familiar persons that appeared on family photographs from recent and remote periods of her life. In the first experimental condition, the pictures represented personally familiar persons present in a specific spatial and temporal context. In a second experimental condition, the pictures showed personally familiar persons who were presented without any specific episodic context. Results indicate that the patient was able to name and identify familiar persons irrespective of the context of presentation (with/without context) and of the time period (recent/remote). No temporal gradient was found using family photographs. Finally, in contrast with familiar persons, J.M. presented a severe anomia for celebrities. Results are discussed in light of recent research in the field.

Anomia↗

Disability and a sense of community belonging. A study among tetraplegic spinal-cord-injured persons in France.

This article presents a study of the identity of persons with motor impairments with regard to the community of disabled persons. The authors used the Tetrafigap survey on the long-term outcome of Tetraplegic Spinal-cord-injured (TSCI) persons, in France, to study the sense of belonging to the community of disabled persons among 1356 TSCI persons in relation to factors of social participation (both sociological and disability-related) and subjective factors (subjective well-being, social perception of disability, perceived disability). The results show that 44% of TSCI persons felt that disabled persons do not constitute a community (the "no-community" group). Of those who recognised the existence of such a community, 34% said they belonged to it (the "in-community" group) and 22% declared they did not (the "out-community" group). People in the "no-community" group tended to be more socially integrated, whilst those in the "in-community" group tended to have greater social and clinical difficulties. The "out-community" group was more diverse, being made up of both autonomous persons and dependent persons suffering from complications. Factors related to the sense of community belonging were identified using bivariate analysis and multiple logistic regression. Subjective well-being appeared to be independent of any sense of community belonging. However, the authors found a gender difference: women in the "in-community" group described themselves as having a poorer level of well-being than women in the other two groups. The results are discussed in terms of two views on the social treatment of disabilities: universalism and assimilation vs. particularism and positive identity and the growth of the disability movement.

Activities of Daily Living↗

The comorbidity of bipolar disorder and axis II personality disorders: prevalence and clinical correlates.

OBJECTIVES: Many studies have examined the prevalence and predictive validity of axis II personality disorders among unipolar depressed patients, but few have examined these issues among bipolar patients. The few studies that do exist suggest that axis II pathology complicates the diagnosis and course of bipolar disorder. This study examined the prevalence of axis II disorder in bipolar patients who were clinically remitted. METHODS: We assessed the co-occurrence of personality disorder among 52 remitted DSM-III-R bipolar patients using a structured diagnostic interview, the Personality Disorder Examination (PDE). RESULTS: Axis II disorders can be rated reliably among bipolar patients who are in remission. Co-diagnosis of personality disorder occurred in 28.8% of patients. Cluster B (dramatic, emotionally erratic) and cluster C (fearful, avoidant) personality disorders were more common than cluster A (odd, eccentric) disorders. Bipolar patients with personality disorders differed from bipolar patients without personality disorders in the severity of their residual mood symptoms, even during remission. CONCLUSIONS: When structured assessment of personality disorder is performed during a clinical remission, less than one in three bipolar patients meets full syndromal criteria for an axis II disorder. Examining rates of comorbid personality disorder in broad-based community samples of bipolar spectrum patients would further clarify the linkage between these sets of disorders.

Adolescent↗

A tale of two visions: can a new view of personality help integrate psychology?

Personality psychology studies how psychological systems work together. Consequently, the field can act as a unifying resource for the broader discipline of psychology. Yet personality's current fieldwide organization promotes a fragmented view of the person, seen through such competing theories as the psychodynamic, trait, and humanistic. There exists an alternative--a systems framework for personality--that focuses on 4 topics: identifying personality, personality's parts, its organization, and its development. This new framework and its view of personality are described. The framework is applied to such issues as personality measurement, psychotherapy outcome research, and education. The new framework may better organize the field of personality and help with its mission of addressing how major psychological systems interrelate.

Humans↗

Personality disorder traits, family environment, and alcohol misuse: a multivariate behavioural genetic analysis.

AIMS: This study seeks to estimate the extent to which a common genetic and environmental basis is shared between (i) traits delineating specific aspects of antisocial personality and alcohol misuse, and (ii) childhood family environments, traits delineating broad domains of personality pathology and alcohol misuse. DESIGN: Postal survey data were collected from monozygotic and dizygotic twin pairs. SETTING: Twin pairs were recruited from Vancouver, British Columbia and London, Ontario, Canada using newspaper advertisements, media stories and twin clubs. PARTICIPANTS: Data obtained from 324 monozygotic and 335 dizygotic twin pairs were used to estimate the extent to which traits delineating specific antisocial personality traits and alcohol misuse shared a common genetic and environmental aetiology. Data from 81 monozygotic and 74 dizygotic twin pairs were used to estimate the degree to which traits delineating personality pathology, childhood family environment and alcohol misuse shared a common aetiology. MEASUREMENTS: Current alcohol misuse and personality pathology were measured using scales contained in the self-report Dimensional Assessment of Personality Pathology. Perceptions of childhood family environment were measured using the self-report Family Environment Scale. FINDINGS: Multivariate genetic analyses showed that a subset of traits delineating components of antisocial personality (i.e. grandiosity, attention-seeking, failure to adopt social norms, interpersonal violence and juvenile antisocial behaviours) are influenced by genetic factors in common to alcohol misuse. Genetically based perceptions of childhood family environment had little relationship with alcohol misuse. CONCLUSIONS: Heritable personality factors that influence the perception of childhood family environment play only a small role in the liability to alcohol misuse. Instead, liability to alcohol misuse is related to genetic factors common a specific subset of antisocial personality traits describing conduct problems, narcissistic and stimulus-seeking behaviour.

Adolescent↗

Interactive model of women's stressors, personality traits and health problems.

Theories have linked various stressors with health problems, and some studies have identified personality traits that enhance health. However, few studies have examined the interaction among women's stressors, personality traits and their health. This retrospective study (1996-1997) analysed the effects of women's major stressors and personality traits on symptoms of health problems, and developed a model of women's health based on the interaction among these factors. A convenience sample of 300 women aged between 18 and 66 years completed a questionnaire that measured three types of stressors, eight personality traits and 40 symptoms of health problems. Principle components and factor analyses identified the best items to measure the stressors, traits and problems. New reduced data subsets were constructed for classification tree analyses to identify the effects of stressors and personality traits on women's health. Women with medium or high stressors and low assertiveness, low hardiness, or the inability to express their feelings, were more likely to report physical symptoms than women who were stronger in these personality traits. Also, women with medium or high stressors and low to medium trust or love relationships were very likely to report high emotional symptoms, as were women with high trust or love, who did not express their feelings. An interactive model of women's health was supported. The amount of women's stressors and their personality traits may increase or diminish their stress response and affect their health. Nurses can identify women with high stressors and unhealthy personality traits that increase their risk for stress-related illnesses, and assist these women to modify their stressors or personality traits to enhance their health.

Adolescent↗

Public dental health care program for persons with disability.

The objectives of the study were (1) to describe the organization and content of the Danish public oral health care program for persons with disability, and (2) to analyse possible variations in relation to the goals and requirements set by the health authorities. Data were collected by means of self-administered questionnaires completed by the person responsible locally for the program in each municipality. The response rate was 84%. The following topics were included: (1) Number of persons attending the program, (2) procedure for identification of persons eligible for the program, (3) payment of service, (4) providers of oral health care, (5) special training of staff, 6) dental services delivered, (7) ethical issues, and (8) patient rights. Less than one-third of persons estimated by the health authorities were enrolled in the program. On average, 0.4% of the municipal population attended the program, ranging from 0.03% to 1.53%. In large municipalities, and where internal providers delivered oral health care, relatively more persons were enrolled in the program (p < 0.001). Overall, more than 20 categories of personnel were involved in the selection procedure; attitude and lack of knowledge of oral health and oral health care for persons with disability were barriers to equal access to the program. Preventive dental services were the most frequent services delivered, although relatively few oral hygienists were involved in the program. Special training was most frequent in large municipalities. To secure equal access for persons with disability, it is recommended that joint collaboration between smaller municipalities should be made regarding procedures of such programs. Special training of dental personnel and of the staff responsible for selecting persons for the program should be systematically organized at a higher administrative level. The pattern of dental services delivered justifies further involvement of oral hygienists in the program.

Aged↗

Child and adolescent psychiatric disorders predicting adult personality disorder: a follow-up study.

The objective of this study was to examine associations between childhood and adolescent psychiatric disorders and adult personality disorders in a group of former child psychiatric inpatients. One hundred and fifty-eight former inpatients with a mean age of 30.5 +/- 7.1 years at investigation had their childhood and adolescent Axis I disorders, obtained from their medical records, coded into DSM-IV diagnoses. Personality disorders in adulthood were assessed by means of the DSM-IV and ICD-10 Personality Questionnaire (DIP-Q). The predictive effects of child and adolescent Axis I disorders on adult personality disorders were examined with logistic regression analyses. The odds of adult schizoid, avoidant, dependent,borderline and schizotypal personality disorders increased by almost 10, five, four, three and three times, respectively, given a prior major depressive disorder. Those effects were independent of age, sex and other Axis I disorders. In addition, the odds of adult narcissistic and antisocial personality disorders increased by more than six and five times, respectively, given a prior disruptive disorder, and the odds of adult borderline, schizotypal, avoidant and paranoid personality disorders increased between two and three times given a prior sub-stance-related disorder. The results illustrate an association between mental disorders in childhood and adolescence and adult personality disorders. Identification and successful treatment of childhood psychiatric disorders may help to reduce the risk for subsequent development of an adult personality disorder.

Adolescent↗

Family history of DSM-III-R dramatic personality disorder cluster and functioning in patients with major depressive disorder.

Clinicians and researchers have noted that personality dysfunction related to borderline personality significantly predicts a poorer course in major depressive disorder. There is also some evidence that some aspects of personality are heritable. The goal of this report was to determine whether family history of dramatic personality disorder cluster indicated differences in functioning in patients with major depressive disorder. Patients with major depression were divided into two groups: those with a family history of dramatic personality disorder cluster (N = 49) and those without (N = 22). These were the clinical groups. A screened normal group was also added to determine how far the clinical groups differed from ordinary functioning (N = 31). Compared with the other clinical group, the group with the family history of dramatic personality disorder tended, in general, to have fewer personality traits as measured by the Personality Disorder Examination, similar Hamilton Anxiety and Depression scores and several significantly better functioning measures. It appears that a family history of dramatic personality disorder cluster identifies a group with different, but not necessarily lower, levels of functioning. Implications of these findings are discussed.

Depressive Disorder↗

Personality disorder comorbidity in early-onset versus late-onset major depression in Japan.

This study explored the comorbidity of DSM-III-R personality disorders in early-onset versus late-onset major depression in Japan. The subjects were 117 consecutive outpatients with major depression, with 26 classified as having an early onset (first depressive episode at age 22 or earlier) and 91 classified as having a late onset (first depressive episode at age 23 or later). Personality disorders were assessed using the Structured Clinical Interview for DSM-III-R Personality Disorders after a 2-month antidepressant treatment. The results indicated that early-onset major depression was characterized by greater personality disorder comorbidity than late-onset major depression in Japan. Subjects with any one cluster A or B personality disorder were more prevalent in the early-onset group. In terms of each personality disorder, histrionic, narcissistic, and borderline patients were more prevalent, and the number of criteria met for schizotypal and cluster B personality disorders was significantly larger in early-onset major depression after corrections for age and gender. The results suggested that the higher prevalence of personality pathologies in early-onset major depression may reflect a higher likelihood to convert into bipolar disorders or a stronger impact of having experienced depressive episodes in young individuals. The possibility that the predisposing personality pathology may be different in early-onset and late-onset major depression is also discussed.

Adult↗

Executive and nonexecutive neuropsychological functioning in antisocial personality disorder.

OBJECTIVE: To examine the relationships between antisocial personality disorder and executive abilities as well as antisocial personality disorder with other domains of cognitive functioning. BACKGROUND: Previous research has suggested that antisocial personality disorder is associated with impaired executive functioning. However, methodological limitations of past research have resulted in inconsistent findings. METHODS: Executive functioning and other cognitive abilities were compared in four demographically matched groups of middle-aged community dwelling male veterans (N = 336). The groups were: (A). those with active antisocial personality disorder psychopathology; (B). those with a lifetime prevalence of antisocial personality disorder but inactive antisocial personality disorder psychopathology; (C). a nonantisocial personality disorder psychiatrically matched control group; and (D). a normal control group. RESULTS: Multivariate analysis of variance revealed that the four groups were not statistically significantly different on measures of executive functioning or other cognitive abilities. CONCLUSIONS: Those with antisocial personality disorder perform at comparable levels to psychiatric and normal controls with respect to executive functioning and other domains of cognitive ability (i.e., language, memory, visuospatial, and motor abilities). An incidental finding was that, over time, the antisocial personality disorder groups improved more than control groups on a measure of general intellectual aptitude.

Adult↗

Suicide and deliberate self-harm in personality disorders.

PURPOSE OF REVIEW: This article reviews literature published over the period January 2004-May 2005 on suicidal behaviour and self-harm in personality disorders. RECENT FINDINGS: Studies have confirmed that personality disorders and their co-morbidity with other psychiatric conditions are risk factors for both fatal and nonfatal suicidal behaviours, and self-mutilation. Negative life events, childhood sexual abuse, difficulties in social functioning, deficits in future-directed thinking and time perception, as well as familial and neurocognitive factors may be related to increased suicide risk in individuals with borderline and other personality disorders. Findings seem to confirm that suicidality and self-injurious behaviour are efficient DSM-IV diagnostic criteria for borderline personality disorder. Out of several psychosocial and pharmacological interventions for treating suicidality in personality disorders, only one randomized, controlled study has recently been published. Medico-legal concerns related to the clinical management of chronically suicidal patients, including hospitalization and alternative treatment approaches, are also discussed. SUMMARY: Although recent studies have contributed to the theoretical knowledge and clinical practice, there are unsettled questions that should be addressed in the future. More randomized, controlled trials evaluating the efficacy of interventions in suicidal individuals with personality disorders should be conducted. As the majority of studies conducted to date have concentrated on borderline personality disorder and antisocial personality disorder, the prevalence and risk factors for suicidal behaviours and self-mutilation in other personality disorders require further clarification. The introduction of unified nomenclature related to suicidal behaviours and self-mutilation would facilitate comparability of results across studies.

Comorbidity↗

Attachment styles and personality disorders: their connections to each other and to parental divorce, parental death, and perceptions of parental caregiving.

Attachment theory was explored as a means of understanding the origins of personality disorders. We investigated whether adult attachment styles and personality disorders share a common underlying structure, and how both kinds of variables relate to family background factors, including parental death, parental divorce, and current representations of childhood relationships with parents. A nonclinical group of 1407 individuals, mostly adolescents and young adults, were surveyed about their attachment styles, parental marital status, parental mortality status, perceptions of treatment by parents in childhood, and 13 personality disorders. Results indicated substantial overlap between attachment and personality-disorder measures. Two of the personality-disorder dimensions are related to the two dimensions of the attachment space; that is, there is a two-dimensional space in which both the attachment patterns and most of the personality disorders can be arrayed. The one personality-disorder factor that is unrelated to attachment appears akin to psychopathy. Both personality disorders and attachment styles were associated with family-of-origin variables. Results are discussed in terms of encouraging further research to test the idea that insecure attachment and most of the personality disorders share similar developmental antecedents.

Adult↗

Personality processes and problem behavior.

This article introduces the special issue of Journal of Personality on personality and problem behavior. There is growing evidence that various dimensions of personality are associated with a broad range of problem behaviors such as drug and alcohol use, sexual risk-taking, interpersonal violence, and gambling. To date, research on personality and problem behavior has focused almost exclusively on documenting simple, direct associations between personality traits and problem behaviors. This article proposes an expanded research agenda, a second generation of research and theory on the role of personality in problem behavior. The agenda specifies two major classes of second-generation hypotheses. Moderator hypotheses concern the conditions under which the influence of personality on problem behavior is magnified, weakened, or eliminated. Mediator hypotheses concern the causal processes that underlie the influence of personality on problem behavior. Articles in the special issue, which are summarized in this introduction, exemplify the proposed second generation of research on personality and problem behavior.

Health Behavior↗