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PubMed2004

Screening for personality disorder: a comparison of personality disorder assessment by patient and informants.

The Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II Version 2.0) is becoming the most favoured instrument to measure personality disorder but takes up to an hour to complete. The Standardized Assessment of Personality (SAP), an informant-based measure, takes 10 to 15 minutes to complete. Both instruments have been validated independently. This study aimed to determine whether the SAP is a suitable screening instrument for personality disorder as measured by the SCID-II. Fifty-seven psychiatric patients were assessed for personality disorder using both the SAP and the SCID-II. The SAP assessments were conducted blind to the results of the SCID-II assessments. Agreement between the two instruments in this population was low (kappa = 0.3). The level of agreement differed between personality disorder categories, ranging from kappa = 0.4 (antisocial) to 0.1 (narcissistic). In this population of patients, the SAP proved to be a poor screen for the SCID-II. The study highlights the discrepancy between informant and self-report assessments for personality disorder.

Adult↗
PubMed1994

The five-factor model of personality as a framework for personality-health research.

The NEO Five Factor Personality Inventory (NEO-FFI; Costa & McCrae, 1989) and representative personality scales drawn from health psychology were administered to 2 samples of male military recruits (Ns = 296 and 502). Factor analysis of health-related personality scales revealed 3 conceptually meaningful domains. Examination of these domains and their constituent scales, with reference to the 5-factor model of personality, permits 3 general conclusions. First, most health-relevant dimensions and scales appear to be complex mixtures of broad personality domains. Second, variation in many health-related personality instruments is explained to a significant degree by the 5-factor model. Third, 2 of the 5 personality domains (i.e., conscientiousness and openness) appear to be substantially neglected in health psychology research.

Adult↗
PubMed1994

Genetics of personality disorders: perspectives from personality and psychopathology research.

Although the field is young, studies pertinent to genetic hypotheses have accumulated for several personality disorders. Genetic links to personality disorders from the domains of normal personality and Axis I disorders are reviewed. Evidence of a link to schizophrenia is clearest for schizotypal and less conclusive for paranoid and schizoid personality disorders. A genetic association between borderline personality disorder and affective disorders has not been clearly supported, but there may be a subtype genetically linked to affective disorders. Evidence of genetic influence is mixed for obsessive-compulsive personality disorder. In general, greater attention to dimensional phenotypic measures and multivariate designs can yield more definitive answers regarding the correct subtyping and probable etiology of personality disorders.

Diseases in Twins↗
PubMed2005

Personal assistants' conceptions of their cooperation in the rehabilitation of disabled persons.

Personal assistants assist persons with severe disability in the performance of their daily activities. The law that covers the right to personal assistance is intended to strengthen the disabled individual's position as a member of society. The aim of the study was to describe personal assistants' conceptions of their cooperation in the rehabilitation of disabled persons. A qualitative method with a phenomenographic approach was used. Six personal assistants were interviewed. Strategic selection of the participants was carried out in order to obtain as wide a variation in conceptions as possible. The results showed that, apart from the factors related to the assistants, factors related to the disabled persons and the environment were of major significance for rehabilitation. The conceptions generated by the study were presented in the form of main categories and subcategories. Four main categories were developed: the meaning of will; the professional role; to consider ability; and awareness of the environment.

Adult↗
PubMed2002

Personality, personal model beliefs, and self-care in adolescents and young adults with Type 1 diabetes.

This study compared 3 models of association between personality, personal model beliefs, and self-care in a cross-sectional design. These models were as follows: (a) Emotional stability determines self-care indirectly through personal model beliefs, and conscientiousness is a direct predictor of self-care; (b) emotional stability determines self-care indirectly through personal model beliefs, and conscientiousness moderates the association between beliefs and self-care; (c) both emotional stability and conscientiousness determine self-care indirectly through personal model beliefs. Participants (N = 358, aged 12-30 years) with Type 1 diabetes completed measures of personality, personal model beliefs, and self-care. Structural equation modeling indicated that Model C was the best fit to the data.

Adolescent↗
PubMed1988

The Munich Personality Test (MPT)--a short questionnaire for self-rating and relatives' rating of personality traits: formal properties and clinical potential.

The Munich Personality Test (MPT) is a brief questionnaire for the assessment of six personality dimensions proper (Extraversion, Neuroticism, Frustration Tolerance, Rigidity, Isolation Tendency, Esoteric Tendencies), one additional scale (Schizoidia, composed of the two shortest scales, Isolation Tendency and Esoteric Tendencies); an Orientation towards Social Norms, which might bias the rating, and the Motivation to perform the rating adequately can be ascertained by means of two control scales. There are two test versions, one for self-rating, the other one for a rating by a key person from the subject's social surroundings ("relatives' rating"). The instruction of both scales explicitly relates to times of mental and physical health in order to reduce the influence of symptoms of a disease on the values of the scales. The data presented indicate a highly consistent factorial structure of self-ratings and relatives' ratings, a significant concordance of both kind of ratings, a sufficient to marked degree of internal consistency of the test scales depending on the number of items in the scales, a fair degree of retest reliability after approximately 1 year and also, though less markedly, after around 7 years in psychiatric patients, and significant differences between groups of psychiatric patients and healthy subjects in all personality scales proper, partially depending on the type of the mental disorder. Judging from relatives' ratings and from other authors' data obtained in recovered patients, these differences cannot be fully explained by the influence of symptoms on the ratings. On the other hand, secondary changes of personality after brain damage have been demonstrated by other authors using a modified testing procedure. On the whole, the MPT offers a fairly differentiated picture of the personality structure in mental patients and healthy subjects.

Adult↗
PubMed1989

Clinical differentiation between major depression only, major depression with panic disorder and panic disorder only. Childhood, personality and personality disorder.

A consecutive sample of 298 nonpsychotic psychiatric outpatients was classified according to DSM-III and divided into 4 diagnostic groups: pure major depression, mixed major depression/panic disorder, pure panic disorder and a remaining group of other disorders. The patients' report of childhood relationship to parents and siblings, family atmosphere, their own personality characteristics as children and precipitating events were compared in the various groups. In addition, differences in personality and frequencies of personality disorders were investigated by means of various instruments. Our results show that the type of relationship to parents in childhood differed in the various groups. The mother seems to be the most crucial person for the development of depression, the father for the development of panic disorder. Patients with major depression are more obsessive and patients with panic disorder more infantile and avoidant with less control of their personality. Finally, patients with mixed conditions are more in accordance with the DSM-III anxious personality disorder cluster.

Adult↗
PubMed2002

Assessment is not enough: the SPA should participate in constructing a comprehensive clinical science of personality. Society of Personality Assessment.

Several proposals for a comprehensive clinical science of personality are enumerated in this Klopfer award article, namely (a) the need to integrate the study of personality within a framework of universal principles from which its theories can be derived, its categories organized, its assessment tools constructed, and its therapeutic interventions designed; (b) the wisdom of conceptualizing personality disorders, not as discrete "disease entities" but as psychological prototypes; (c) the shift from the Diagnostic and Statistical Manual of Mental Disorders Axis I to Axis II distinction to a 3-part complexity continuum demarcated by simple reactions, complex syndromes, and personality patterns; (d) the utility of expanding the range and comparability of routinely appraised clinical domains; and (e) the refining and differentiation of personality style and personality pathology subtypes.

Diagnostic and Statistical Manual of Mental Disord↗
PubMedDate not supplied

Job experiences of personal assistants employed in a consumer-directed personal assistance services programs.

The demand for personal assistants for persons with disabilities is outpacing the supply. The objective of this pilot project was to describe the training and supervision needs of personal assistants, the nature of the assistant-consumer relationship, and the job satisfaction associated with being employed as a personal assistant. Telephone interviews were conducted with 24 personal assistants. All of the participants reported being competent and well trained in their work and 79% of the participants reported being very satisfied with their work as a personal assistant. All also reported they had an opportunity to accomplish something worthwhile in their jobs. Participants reported high levels of satisfaction with their relationship with their employers and with their jobs in general, despite dissatisfaction with low wages. Further research is needed to identify strategies for increasing the supply of personal assistants, who are pivotal to helping consumers maintain their independence.

Adult↗
PubMed2004

Proprioceptive weighting changes in persons with low back pain and elderly persons during upright standing.

The purpose of this study was to examine whether postural instability observed in persons with spinal pain and in elderly persons is due to changes in proprioception and postural control strategy. The upright posture of 20 young and 20 elderly persons, with and without spinal pain, was challenged by vibrating ankle muscles (i.e. tibialis anterior, triceps surae) or paraspinal muscles. Center of pressure displacement was recorded using a force plate. Persons with spinal pain were more sensitive to triceps surae vibration and less sensitive to paraspinal vibration than persons without spinal pain. Elderly persons were more sensitive to tibialis anterior vibration than young healthy persons. These results suggest that spinal pain and aging may lead to changes in postural control by refocusing proprioceptive sensitivity from the trunk to the ankles.

Adult↗
PubMed2000

The personal-group discrepancy: Is there a common information basis for personal and group judgment?

In contrast to motivational accounts of the personal-group discrepancy, results from this article suggest that the discrepancy is explained by aggregating different sets of comparison outcomes for either personal or group ratings. Results from a longitudinal study with East German (the minority group) and West German (the majority group) samples confirm the personal-group discrepancy and support our approach. First, social comparisons influenced evaluations of economic situation at both group and personal levels. Second, ratings of group versus personal economic situation were based on different sets of comparisons. Third, the mean structure of both sets of comparison outcomes mirrored the personal-group discrepancy. Fourth, an interaction between personal-group discrepancy and group status supported the authors' suggestions-concerning the direction of the discrepancy.

Adolescent↗
PubMed1998

Personal sampling of particles in adults: relation among personal, indoor, and outdoor air concentrations.

To investigate the validity of outdoor particulate matter with a 50% cutoff diameter of 10-microm (PM10) concentrations as a measure of exposure in time series studies, the association between personal and outdoor concentrations, within subjects, over time was investigated. Repeated measurements of personal, indoor, and outdoor PM10 were conducted among 37 nonsmoking, 50- to 70-year-old adults, living in Amsterdam, Netherlands, 1994. Regression analyses were conducted for each subject separately, and the distribution of the individual regression and correlation coefficients was investigated. Furthermore, the extent to which differences among personal, indoor, and outdoor concentrations could be explained was studied. The median Pearson's R between personal and outdoor concentrations was 0.50. Excluding days with exposure to environmental tobacco smoke (ETS) improved the correlation to a median R of 0.71. The estimated cross-sectional correlations were lower, 0.34 and 0.50, respectively. Outdoor concentrations (mean, 42 microg/m3) exceeded indoor concentrations (mean, 35 microg/m3) but underestimated personal exposures (mean, 62 microg/m3). The major part of the difference between personal and outdoor concentrations could be attributed to exposure to ETS, living along a busy road, and time spent in a vehicle. The results show a reasonably high correlation between personal and outdoor PM10 within individuals, providing support for the use of ambient PM10 concentrations as a measure of exposure in epidemiologic studies linking the day-to-day variation in particulate matter air pollution to the day-to-day variation in health endpoints such as mortality, hospital admissions, respiratory symptoms, and lung function.

Aged↗
PubMed1999

Evaluation of Simulated Presence: a personalized approach to enhance well-being in persons with Alzheimer's disease.

OBJECTIVE: To evaluate the efficacy of Simulated Presence, a personalized approach to enhance well-being among nursing home residents with Alzheimer's disease and related dementia's (ADRD). DESIGN: Latin-Square, double blinded, 3-factor design with restrictive randomization of three treatments (the study intervention, a placebo audio tape of a person reading the newspaper, and usual care). The three factors were treatment, time, and facility type. SETTING: Nine nursing homes in Eastern Massachusetts and Southern New Hampshire. PARTICIPANTS: Fifty-four subjects with documented ADRD who were aged 50 years or older, medically stable, had resided in their current nursing home for at least 3 months, and who had no planned discharge. All subjects had a history of agitated or withdrawn behaviors. INTERVENTION: The purpose of Simulated Presence is to provide a personalized intervention for persons with moderate to severe cognitive impairment. Through a unique testing process, some of the best loved memories of the ADRD person's lifetime are identified and then those memories are introduced to the patient in the format of a telephone conversation using a continuous play audio tape system. The intervention may be used for extended periods of time because each repetition is viewed as a fresh, live telephone call as a result of the short-term memory deficit of the person with ADRD. MEASUREMENTS: Direct observations of outcomes included using a newly developed scale, the Scale for the Observation of Agitation in Persons with Dementia, an agitation visual analog scale, the Positive Affect Rating Scale (mood and "interest"), a withdrawal visual analog scale, and facial diagrams of mood. Reported measures included daily staff observation logs of responses to interventions offered, and weekly staff surveys using the short-form Cohen-Mansfield Agitation Inventory and the Multidimensional Observation Scale for Elderly Subjects (mood and "interest"). Severity of dementia was assessed by the Mini-Mental State Exam, the Test for Severe Impairment, the Bedford Alzheimer's Nursing Scale, and the ADL Self-Performance Scale. RESULTS: Chi-square analysis of direct observations, using facial diagrams, revealed that Simulated Presence was equivalent to usual care (P = .141) and superior to placebo for producing a happy facial expression (P = .001). A positive effect was also documented in nursing staff observation logs using Analysis of Variance techniques (ANOVA) for subjects during Simulated Presence phases compared with the placebo phases (P < .001) and usual care phases (P < .001). According to ANOVA analyses of "interest" from weekly surveys, Simulated Presence was superior to both usual care (P = .001) and placebo (P = .008). We were unable to find evidence of significant differences (P < .05) among interventions for other direct observations and weekly reports of overall agitation or mood aspects of withdrawal. Subjects accepted the intervention most of the time, except for five subjects who refused it more than 50% of the time. CONCLUSION: This study provided evidence that Simulated Presence can be effective in enhancing well-being and decreasing problem behaviors in the nursing home setting as a substitute for or complement to usual care.

Aged↗
PubMed1984

Mortality among persons with depressive symptoms and among responders and non-responders in a health check-up. An investigation of persons born in 1905 and followed up from age 66 to 75.

The death rate for persons in Stockholm born in 1905 has been investigated during a 9-year period (1971-1979). In 1971 these persons were invited to participate in a health check-up. Another check-up was carried out 3 years later, during which a psychiatric examination of 589 persons was undertaken. The correlation between depressive disorders and mortality was investigated in two steps. The death rates for those subjects who had responded affirmatively to items in a questionnaire indicating depression were compared with the death rate for the remaining responders. The death rates for those subjects considered to have neurotic disorders or sleeping disturbances in the psychiatric examination were compared with the death rates for the members of a control group considered to be without psychiatric symptoms. Both methods gave fundamentally the same result: there is an excess mortality among persons with depressive symptoms compared to persons without. The death rates were significantly higher in the populations that did not participate in the health check-ups than in those who did. The rates of suicide were also greater in the non-response populations. None of the persons who participated in the 1974 health check-up committed suicide during the next 3 years. The study shows that physically and mentally healthier persons were overrepresented among those who participated in the health check-ups at the ages of 66 and 69.

Accident Proneness↗
PubMed1994

[The role of other persons in prospective memory: dependence on other persons inhibits remembering and execution of a task].

This study investigated how other persons functioned in prospective memory process (PMP) and whether planning in memorization for the task could facilitate an appropriate use of other persons. One-hundred and five undergraduates were divided into 2 (facilitating planning in memorization or not) x 2 (facilitating use of other persons or not) groups. The task was to fill out and mail a questionnaire on a specified day. The main results were as follows; 1) subjects who were facilitated using other persons increased dependence on other persons to remember the task. Dependence inhibited execution of the task, because subjects did not use memory aids so much and could not cope with competitive activities, 2) subjects who were facilitated to plan in memorization increased both execution of task (only in the condition which did not facilitate use of other persons) and use of memory aids. These results suggest that implicit use of other persons could induce negative effects in PMP.

Adult↗
PubMed2005

Influenza vaccination levels among persons aged > or =65 years and among persons aged 18-64 years with high-risk conditions--United States, 2003.

Influenza vaccination is an effective tool for preventing hospitalization and death among persons aged > or =65 years and among persons aged 18-64 years with medical conditions that increase the risk for influenza-related complications. Two national health objectives for 2010 are to increase influenza vaccination coverage to 90% among persons aged > or =65 years and to 60% among persons aged 18-64 years who have one or more high-risk conditions (objectives 14-29a and 14-29c, respectively). To determine influenza vaccination coverage among persons in both targeted groups, CDC analyzed data from the 2003 National Health Interview Survey (NHIS). This report summarizes the results of that analysis, which determined that influenza vaccination coverage among persons aged > or =65 years and persons aged 18-64 years with high-risk conditions remains substantially below 2010 target levels. In addition, racial/ethnic disparities in coverage levels persist in both targeted populations. To improve overall influenza vaccination coverage and reduce racial/ethnic disparities, combinations of evidence-based effective interventions should be implemented, and the influenza vaccine supply should be stabilized.

Adult↗
PubMed1994

The relationship of premorbid personality to subtypes of an affective illness. A replication study by means of an operationalized procedure for the diagnosis of personality structures.

The hypothesis of a relationship between types of premorbid personality and subtypes of an affective illness was tested on the basis of a diagnostically 'blind' assignment of biographical case history data on patients' premorbid development to patterns of personality traits. Data sets of 261 cases with various psychiatric disorders were examined. The rater (R.T.) had to score each item in a list of traits relevant for the diagnosis of the types that had been conceived by D.v.Z. and J.P. The assignment of the ratings to the type concepts was then performed by means of a computer programme. The results regarding the distribution of types over the clinical diagnoses yielded a statistically significant association of the 'affective types' of premorbid personality ('melancholic type' and 'manic type') with affective disorders and the 'neurotoid types' ('anxious insecure type' and 'nervous tense type') with non-affective disorders. Previous findings on the basis of a global rating of types in a smaller sample (n = 42) regarding personality types and subtypes of an affective illness could be replicated by means of the new, operationalized procedure in an enlarged sample (n = 80): On the one hand, a marked preponderance of the 'manic type' of personality was found in bipolar I patients, particularly pronounced in those with a predominantly manic course of the disorder; on the other hand, the 'melancholic type' of personality prevailed in bipolar II and unipolar depressive patients.

Adult↗
PubMed1988

Tonic arousal and activity: relationships to personality and personality disorder traits in panic patients.

Personality theorists have long predicted a relationship between personality traits and autonomic activation. In this study, 48 patients with panic disorder underwent personality assessment by questionnaire (Eysenck Personality Inventory: 48 patients) and by interview (Personality Disorders Examination: 35 patients). Ambulatory heart rate and activity were measured by the Vitalog method and were used as measures of activation and autonomic arousal. There was a significant positive correlation between histrionic traits and activity level and a significant negative correlation between sociability and heart rate. The findings are consistent with previous studies showing a negative relationship between sensation-seeking personality traits and cerebrospinal fluid levels of norepinephrine and a positive relationship between extroversion and cerebrospinal fluid levels of dopamine.

Adult↗