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PubMed1995

[Personality characteristics in ulcer disease. A cohort study].

The purpose of the study was to investigate the direction of a possible relationship between peptic ulcer disease and personality disorders. A cohort study was carried out in Glostrup County, Denmark (population 100,000). A representative sample of 50-years old persons born in 1914 (n = 673) were followed for 20 years. All 673 filled in the Minnesota Multiphasic Personality Inventory (MMPI) in 1964 and 513 were retested with MMPI in 1974. The prevalence of peptic ulcer disease in 1964 was 7% and the average annual incidence in the period 1964-1984 was 2.1 per 1000 persons. The persons with incidental peptic ulcer in 1964-84 had normal MMPI scores in 1964, while persons with peptic ulcer in 1964 had a slight but statistically significant increase in one neuroticism scale (HS) only. The group with prevalent ulcer disease in 1974 exhibited statistically significant increases in the three neuroticism scales (HS, D, HY) and in scale Pd and scale Pt at MMPI retesting. In addition they had statistically significantly higher scores in the three neuroticism scales compared with the other persons who still had normal scores in all scales. It is concluded that personality disorders in persons with peptic ulcer are consequences of the disease and not causal factors.

Cohort Studies↗
PubMedDate not supplied

[Study of the remission period (between crises) of unipolar and bipolar manic depressive disorders. Personal study of 95 patients].

The personality abnormalities observed during unipolar and bipolar manic-depressive disorders are known for years by german psychiatry as depressive temperament. In USA many works based on DSM III criteria have studied personality abnormalities coexisting with depression. The most frequently abnormalities are dependent, avoidant, compulsive, border line personality, observed with a frequency of 48% (P.A. Pilkonis) to 74% of patients (T.M. Shea et al.). But the personality traits or disorders are not the disorders only observed during remissions and intercrisis. Our personal work have studied the other disorders. This work concern pre-morbid period and intercrisis of 95 manic-depressed patients (45 unipolar and 50 bipolar patients). The time of remission is at least three months. Remission is certified by maximum scores of 10 on MADRS, 12 on Bech-Rafaelsen scale. The study of personality traits and other mental disorders is based on DSM III-R criteria. It is completed by Hamilton-Anxiety-Scale, Eysenck Personality Inventory and Beth-Israel Questionnaire of Sifneos. This study shows the following results. In pre-morbid period, the anxiety disorders are statistically more frequent in unipolar patients: generalized anxiety (35%), panic disorder (27%), psychosomatic disorders (30.5%). During intercrisis, the anxiety disorders are statistically more frequent in unipolar patients: generalized anxiety (51.1%), agoraphobia (31.1%) obsessive disorders (26.6%), panic disorder (18.2%). But this co-morbidity with anxious disorders is highly correlated with the incomplete characteristic of remission. During remission the personality abnormalities are similar to american studies, more frequent in unipolar patients, particularly obsessive personality (22.2 to 4%).(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed2004

Personality disorders in a Dutch forensic psychiatric sample: changes with treatment.

BACKGROUND: Evidence on the effectiveness of treatment for personality disorder (PD) is mixed, and there are very few data at all on outcomes for offender patients with PD. In the Netherlands there is nevertheless commitment to treating such people in specialized forensic psychiatric hospitals. AIMS/HYPOTHESES: The main aim was to determine the extent to which, if at all, patients detained under the Dutch TBS provision in the Dr Henri Van der Hoeven Hospital changed during inpatient treatment. METHODS: The study followed a naturalistic design. On admission, the Structured Interview for DSM Personality Disorders (SIDP-R) and the Personality Diagnostic Questionnaire-Revised (PDQ-R) were used to assess DSM axis-II personality disorder pathology. After two years of intensive treatment they were reassessed using self-report questionnaires. RESULTS: Fifty-nine patients (54 men and five women) completed both ratings. At follow-up, group mean indicated a significant reduction in personality disorder pathology as measured by the PDQ-R. Analysis of changes in individual subjects according to a method described by Jacobson and Truax (1991) showed that almost 40% improved reliably (by more than two standard deviations) and more than one quarter of the sample improved to a reliable and clinically significant extent in personality disorder features. CONCLUSIONS AND CLINICAL IMPLICATIONS: The findings of the study are encouraging in terms of reduction of personality disorder psychopathology. Limitations to the study design are acknowledged. Further, it is not known whether this change constitutes substantial reorganization of personality, or whether it reflects a change at a more superficial level. Further follow-up of the patients is necessary to investigate whether the positive changes remain after release from hospital.

Adolescent↗
PubMed2005

Neuroimaging and personality disorders.

Within the past several years, neuroimaging research on personality disorders has begun to develop. Personality disorders can be thought of as trait-like dysfunctional patterns in cognitive, affective, impulse control, and interpersonal domains. These domains of dysfunction have been linked to specific neural circuits. Developments in brain imaging techniques have allowed researchers to examine the neural integrity of these circuits in personality-disordered individuals. This article reviews the neuroimaging literature on borderline personality disorder, antisocial personality disorder (including psychopathy) and schizotypal personality disorder. Functional and structural studies provide support for dysfunction in fronto-limbic circuits in borderline and antisocial personality disorder, whereas temporal lobe and basal striatal-thalamic compromise is evident in schizotypal personality disorder.

Antisocial Personality Disorder↗
PubMedDate not supplied

Personality dimensions and criminal arrest.

Previous studies have implicated antisocial personality disorder in criminal behavior, but little is known about the association between "normal" personality dimensions and arrest. We investigated the relationships between these personality dimensions and prior arrest in a sample of adults participating in a longitudinal epidemiological study. Between 1993 and 1999, psychiatrists re-examined subjects who were originally interviewed in Baltimore in 1981 as part of the Epidemiologic Catchment Area study; the psychiatrists diagnosed axis I and axis II disorders according to DSM-IV criteria. A total of 611 subjects also completed the Revised NEO Personality Inventory (NEO-PI-R), which assesses five broad factors and 30 facets of normal personality. History of criminal arrest in Maryland in the period 1981 to 1993 was determined from the state criminal justice database. Student's t test and logistic regression were used to evaluate relationships between NEO personality scores and prior arrest. Controlling for demographic characteristics, alcohol or drug use disorders, and DSM-IV personality disorder scores, the odds of prior arrest increased with scores on angry hostility, impulsiveness, and excitement-seeking dimensions. Prior arrest was inversely related to scores on trust, straightforwardness, compliance, modesty, dutifulness, and deliberation dimensions. The results suggest that specific dimensions of normal personality are related to criminal arrest in the community.

Adult↗
PubMed1994

Personality disorders among the relatives of schizophrenia patients.

In light of current linkage studies in schizophrenia, research on the "schizophrenia spectrum" deserves increased attention for an exact determination of the affected phenotype: Those disorders that have a much higher prevalence among biological relatives of schizophrenia patients are supposed to share common etiological factors with "core" schizophrenia. However, there is controversy over which of the DSM-III-R personality disorders should be included in the spectrum. In a controlled family study of inpatients with a DSM-III-R diagnosis of schizophrenia (n = 101), schizophreniform and schizoaffective disorders (n = 69), and unipolar major depression (n = 160), familial rates of personality disorders were assessed through personal interviews and compared with prevalence rates in 109 control families from the community. As predicted, schizotypal personality disorder occurred more frequently in the nonpsychotic relatives of schizophrenia probands (2.1%) than in the families of unscreened controls (0.3%). Paranoid personality disorder was more frequent in relatives of probands with unipolar depression (2.9%) than in relatives of schizophrenia patients (1.7%), and controls revealed the lowest rate (0.9%). Schizoid personality disorder, however, was extremely rare in all sample groups (between 0.3% and 0.7%), providing no sufficient statistical power for detection of group differences. Further analysis of the DSM-III-R criterion symptoms of schizotypal personality disorder demonstrated that items describing "negative" symptomatology are the main source of familial aggregation, but "psychotic-like" personality features are also contributing factors.

Adult↗
PubMed2005

Personality differences in schizophrenia are related to performance on neuropsychological tasks.

Altered cognition and personality appear to emerge in tandem and adversely affect outcome in schizophrenia, yet little research has been done to determine whether these are related or independent domains. In this study, the relationship between the Big Five personality traits--neuroticism, extraversion, openness, agreeableness, conscientiousness--and cognitive and motor performance in outpatients with chronic, clinically stable schizophrenia (N = 30) and age-matched healthy comparison subjects (N = 45) was examined. Subjects completed tests of attention, executive and motor functions, and the NEO-Five Factor Personality Inventory. Patients scored significantly higher on neuroticism and lower on extraversion and agreeableness, but after variance due to neuropsychological performance was statistically removed from NEO scale scores, personality dimensions and profiles no longer differed between groups. Neuropsychological performance and demographic variables, but not diagnosis, uniquely accounted for statistically significant amounts of personality variance, and neuropsychological task performance was correlated with personality dimensions in both patients and comparison subjects. These cross-sectional data provide preliminary evidence that personality dysfunction in schizophrenia may be mediated by disease-related changes in cognitive operations, or the neural processes underlying them. Longitudinal studies utilizing more comprehensive measures of neurocognitive performance are needed to define further the relationship between neuropsychological function and personality in schizophrenia.

Adult↗
PubMed1992

The five-factor model in personality: a critical appraisal.

This critical appraisal aims to position the five-factor model within the multifaceted field of personality psychology by highlighting six important limitations of the model. These are the model's (a) inability to address core constructs of personality functioning beyond the level of traits; (b) limitations with respect to the prediction of specific behavior and the adequate description of persons' lives; (c) failure to provide compelling causal explanations for human behavior and experience; (d) disregard of the contextual and conditional nature of human experience; (e) failure to offer an attractive program for studying personality organization and integration; and (f) reliance on simple, noncontingent, and implicitly comparative statements about persons. The five-factor model is essentially a "psychology of the stranger," providing information about persons that one would need to know when one knows nothing else about them. It is argued that because of inherent limitations, the Big Five may be viewed as one important model in personality studies but not the integrative model of personality.

Cross-Cultural Comparison↗
PubMed1994

Alcohol and drug abusers subtyped by antisocial personality and primary or secondary depressive disorder.

Our data show that when substance abusers are subtyped simultaneously by antisocial personality disorder and the onset of depression relative to alcohol or drug abuse, groups of people with unique personality and affective profiles are identified. The profiles are represented by measures of affect-related personality variables such as trait anxiety, trait depression, histrionic traits, sensation seeking, and novelty seeking. These measures were chosen in an attempt to show that a "low arousal" personality type may be associated with antisocial personality and may thus indirectly be linked to a certain type (i.e., ASP/nondepressed) of substance abuser. By using a multi-symptomatic typological schema (i.e., a constellation of diagnostic categories rather than just one), we can show that different personality or affective profiles are indeed associated with certain subtypes of substance abusers and that depressed people who use drugs or alcohol are different affectively from antisocial types. We also show that the relationship between "low" and "high" arousal personality profile and subtypes based on co-morbid psychopathology is highlighted even more when we take into account the onset of dysthymia or depression that is primary versus secondary to substance abuse. Our findings are in accord with others' descriptions of the "affective arousal" dimensions of personality and are the first to link these dimensions with subtypes based on ASP and depression.

Adult↗
PubMed1993

Personality disorder in obsessive-compulsive volunteers, well comparison subjects, and their first-degree relatives.

OBJECTIVE: The authors sought to determine the frequency of DSM-III personality disorders in subjects with obsessive-compulsive disorder, well comparison subjects, and their first-degree relatives. METHOD: Thirty-two subjects with obsessive-compulsive disorder and 33 age-(within 5 years) and gender-matched well comparison subjects were assessed with the Structured Interview for DSM-III Personality Disorder and several self-report instruments. Their first-degree relatives were assessed in a blind manner with the same instruments. RESULTS: Subjects with obsessive-compulsive disorder were more likely than well comparison subjects to have a personality disorder, but compulsive personality was not the most frequent. No significant differences were found in the prevalence of personality disorders among first-degree relatives, including compulsive personality, or in obsessional, hysterical, or oral character traits. CONCLUSIONS: Personality disorders are highly prevalent among patients with obsessive-compulsive disorder, but the data do not support a relationship between obsessive-compulsive disorder and compulsive personality.

Adult↗
PubMed1994

Personality test scores as predictors of alcoholism almost a decade later.

OBJECTIVE: Comparisons of alcoholic and control subjects have revealed potential differences on a variety of personality tests. However, these results are difficult to interpret because subgroups of alcoholic subjects with antisocial personality disorder were often included in the overall analyses, and because testing was usually carried out while alcoholic subjects were in withdrawal. This article evaluates whether individuals' personality test scores at approximately age 20 predict their risk of subsequent development of alcohol abuse or dependence by about age 30. METHOD: As part of a larger prospective study of sons of alcoholic and control subjects, subsets of up to 78 subjects (39 matched pairs) out of a sample of 223 men took various personality tests that included the Eysenck Personality Inventory, subtests of the MMPI, and evaluations of locus of control and anxiety. An average of more than 9 years later, the incidence of alcohol abuse or dependence in these 223 subjects was determined by structured interviews. RESULTS: The 55 men who subsequently went on to develop alcohol abuse or dependence did not differ on any of the personality tests from the 168 men who did not develop alcoholism. CONCLUSIONS: These data are consistent with prospective studies indicating that except for antisocial personality disorder, it is difficult to identify a reliable personality profile associated with an individual's risk of alcoholism.

Adolescent↗
PubMed1993

Personality disorders: model for conceptual approach and classification. Part I: General model.

In this article we present data suggesting that one core deficit in personality represents a common dimension extending across most categories of personality disorders (PDs), whereas clinically discrete syndromes classified as PDs in DSM IIIR are categorical maladaptive types related orthogonally to the common borderline dimension. In a sample of 121 subjects with PDs and 67 controls, persons with PDs and without PDs manifested similar profiles on the Millon Clinical Multiaxial Inventory (MCMI) scales for various behavior styles. Conversely, the two groups consistently differed with respect to the MCMI borderline scale: in contrast to non-PD persons, those with PDs were strikingly more borderline and typically scored above 75 points (the latter has been established as the cut off for the diagnosis of Borderline PD). Likewise, persons with PDs scored significantly higher on the Diagnostic Interview for Borderlines than the control group. These results suggest that: i) most symptoms usually considered typical of the borderline personality characterize other PDs as well; ii) borderline features seem to be characteristic of persons with PDs and can be used to distinguish PDs vs. non-PDs. Therefore, symptoms widely regarded as typical of the borderline personality characterize other PDs as well. This shared dimension may explain the overlap in categorical diagnoses of individual PDs. Moreover, this shared dimension may be efficiently used as the classificatory principle for PDs. In Part II of this article, we present a model that classifies deviant behaviors in a systematic way, i.e., combines three levels of functioning (normal, neurotic, and borderline) with a limited number of categories of (mal) adaptive behavior types.

Borderline Personality Disorder↗
PubMed1993

The health status and health care utilization of deaf and hard-of-hearing persons.

OBJECTIVE: To evaluate whether health habits, self-reported health status, and communication with physicians play a role in the known altered health care utilization patterns of deaf and hard-of-hearing persons. DESIGN: A cross-sectional survey. Respondents were given the choice of completing either a self-administered written survey or an American Sign Language interview-administered survey. POPULATION: Eighty-seven deaf and hard-of-hearing members of various organizations serving this population in southeastern Michigan and 88 hearing patients from a family practice clinic in the same area. RESULTS: Deaf and hard-of-hearing persons visit physicians more frequently (P = .01), have a lower incidence of ever smoking tobacco (P < .0006) and of alcohol use (P = .04), have more difficulties communicating with physicians (P < .001), have trouble understanding physicians (P < .001), and feel less comfortable with physicians (P < .001). Lower current tobacco use among deaf and hard-of-hearing persons was only seen in persons who were not educated beyond high school. Increased frequency of physician visits for deaf and hard-of-hearing persons was especially noticeable in the group of persons 60 years of age and older. Our finding that use of interpreters is associated with increased utilization and decreased understanding suggests deaf and hard-of-hearing patients presenting with interpreters warrant more focused attention from physicians. Reasons for seeing physicians did not explain the difference in frequency of physician visits between the two groups. CONCLUSIONS: Deaf and hard-of-hearing persons report a lower subjective health status and higher physician utilization, as well as substantial communication difficulties with physicians. They also report better health-related behaviors, namely less use of tobacco and alcohol. The use of interpreters did not decrease physician utilization or improve the understanding of physicians by these persons. Overall, our results underscore the fact that deaf and hard-of-hearing persons constitute a minority population that experiences considerable difficulties in the patient-physician relationship.

Adult↗
PubMed1992

Category-related components in visual evoked potentials: photographs of faces, persons, flowers and tools as stimuli.

One hundred and sixty black-and-white photographs of faces, persons, tools and flowers constituted the four stimulus categories in the first experimental paradigm. In the second paradigm, 160 black-and-white photographs of persons in a neutral (side view), fighting, greeting and "depressed" postures were used. The same nine female and nine male students volunteered as subjects in both paradigms. EEG responses were recorded through the electrodes F3, F4, Cz, Oz, T5 and T6 and referenced to "linked" mastoid electrodes. Individually averaged EPs and grand averages of the EPs for all 18 subjects were computed as well as bipolar responses for selected pairs of electrodes. Category-related components in the evoked potentials (EPs) were found mainly in the recordings through the midline and the frontal electrodes. These category-specific differences were more prominent, however, in the bipolar recordings between these electrodes and the respective ipsilateral electrodes (T5 or T6) than in the monopolar recordings. Monopolar and bipolar EPs could be divided into those evoked by person stimuli and by non-person stimuli. Category-related differences were demonstrated by computing EP-difference curves related to pairs of stimulus categories. In addition to the statistical analysis of peak amplitudes and peak latencies of the individual curves, a "running" Wilcoxon test was applied and cross-correlation functions between the EPs evoked by different stimulus categories were computed. The "face-related" components of the EPs described in earlier studies could be confirmed. They were prominent in the waves peaking between 130 and 150 ms and between 200 and 230 ms and were stronger when faces rather than full-figure "neutral persons" were used as stimuli. No significant hemispheric differences could be found between any of the EPs. In the second paradigm, EEG responses evoked by person stimuli in a neutral, fighting, greeting or depressed posture exhibited only slight differences, if at all. The "person-responsive" components in the EPs evoked by the photographs of a neutral standing person (side view) were smaller between 120 and 200 ms than in the other three categories in which "expressive" persons were the stimuli.

Adult↗
PubMed2004

[Personal support and mortality: a cohort analysis of the National Questionnaire Survey 1984-86].

OBJECTIVES: The aim of the study is to investigate the association between personal support and mortality experience in Germany. METHODS: Data source is the Life Expectancy Survey of the Federal Institute for Population Research (Wiesbaden). This study comprises the National Questionnaire Survey of the German Cardiovascular Prevention Study (1984-86) and a mortality follow-up (1998). Included are 7240 persons with German nationality aged 31-69 years at baseline. 957 persons (13.2%) died during the observation period from 1984-1998. An additive index combining familiy status and number of persons available in emergency situations was administered as indicator for social support. The multivariate statistical analysis was performed with the cox-regression method. RESULTS: Persons with low or very low personal support yielded in both sexes significantly higher relative risks for mortality during the 14 years of follow-up. The relative risks in the regression models including confounding factors for low personal support were 1.49 (p < 0.01) in males and 1.67 (p < 0.01) in females, and for very low personal support 1.81 (p < 0.05) in males and 2.31 (p < 0.01) in females. CONCLUSIONS: These results are indicating an increasing importance of personal support for the mortality experience in the general population.

Adult↗
PubMed2006

The influence of personal familiarity on object naming, knowledge, and use in dementia.

Reports of semantic dementia patients have shown more accurate identification and use for personal objects than unfamiliar analogs of the same objects (e.g., personal comb versus experimenter's comb) [Bozeat, S., Lambon Ralph, M. A., Patterson, K., & Hodges, J. R. (2002). The influence of personal familiarity and context on object use in semantic dementia. Neurocase, 8, 127-134; Snowden, J. S., Griffiths, H., & Neary, D. (1994). Semantic dementia: Autobiographical contribution to preservation of meaning. Cognitive Neuropsychology, 11, 265-288]. Despite potential clinical implications, the personal object advantage has not been explored in various dementia populations. Sixteen mild to moderate dementia patients were tested with 12-15 of their personal objects and laboratory analog objects. Four tasks were administered: Naming, Gesture, Semantic/Script Generation, and Personal Object Decision (i.e., Is this yours?). Although 25% of the sample performed at chance in identifying personal objects as their own, participants generated more specific information (t=2.3, p=.03) and more accurate gestures (t=2.4, p=.03) for personal objects. Thus, the personal object advantage was observed for script/semantic knowledge and movement sequences, and should be considered in residential planning for various dementia patients.

Activities of Daily Living↗
PubMed2005

Comparison of 1- versus 2-person bag-valve-mask techniques for manikin ventilation of infants and children.

STUDY OBJECTIVE: We compare the mean tidal volumes per weight and peak pressures generated by the 1- and 2-person techniques of bag-valve-mask ventilation in a pediatric model. METHODS: This was a prospective, descriptive study in which postgraduate year 1, postgraduate year 2, and postgraduate year 3 pediatric residents, postgraduate year 2 emergency medicine residents, pediatric emergency department nurses, transport personnel, and paramedics were asked to perform 1- and 2-person bag-valve-mask ventilation on infant and child manikins. Participants were randomly assigned a partner and performed both techniques. Tidal volume and peak pressure were recorded every 15 seconds for 3 minutes by a blinded assistant. RESULTS: Seventy participants, 10 in each group, completed the study. Overall, for the infant- and child-manikin groups, the 2-person technique generated higher mean tidal volume per weight than the 1-person technique (infant: 7.2 versus 5.9; child: 8.8 versus 6.1). Overall, the 2-person technique generated higher mean peak pressures than the 1-person technique (infant: 27.4 versus 22.0; child: 27.2 versus 21.8). Similar results were found among all provider groups. Paramedics were the only providers able to generate a recommended median tidal volume per weight of 10 mL/kg in the child manikin group when using either technique and were the only providers, when using the 2-person technique, to generate a mean tidal volume per weight of 10 mL/kg in the infant group. CONCLUSION: Two-person bag-valve-mask ventilation provided greater mean tidal volumes per weight and peak pressures in the infant- and child-manikin model compared with the 1-person technique.

Allied Health Personnel↗
PubMed2004

The effect of varied fractional inspired oxygen on arm exercise performance in spinal cord injury and able-bodied persons.

OBJECTIVE: To examine the effect of different levels of fractional inspired oxygen (FiO(2)) (15%, 21%, 50%) on peak oxygen consumption (VO(2)peak) during arm exercise in persons with spinal cord injury and in able-bodied controls. DESIGN: Case-control study. SETTING: University medical center in the Netherlands. PARTICIPANTS: Ten able-bodied controls, 6 persons with paraplegia, and 6 persons with tetraplegia. INTERVENTIONS: Inspiration of 15%, 21%, and 50% oxygen during a 15-minute period before and during arm exercise. MAIN OUTCOME MEASURES: Oxygen uptake (VO(2)peak, VO(2)peak/kg), power output, ventilation, and base excess. RESULTS: In the able-bodied controls, significant FiO(2) dependency was seen in power output, VO(2)peak, and VO(2)peak/kg. Persons with paraplegia showed significant FiO(2) dependency in VO(2) and VO(2)/kg. In persons with tetraplegia, no FiO(2) dependency was observed; however, VO(2) and VO(2)/kg were significantly higher at 50% than at 15% FiO(2). Ventilation and base excess did not change in able-bodied controls or in persons with paraplegia with different levels of FiO(2). In persons with tetraplegia, ventilation was significantly higher at 15% than at 50% FiO(2), and base excess did not change. No significant interactions between groups and FiO(2) were observed. CONCLUSIONS: Oxygen consumption during peak arm-cranking exercise is enhanced with an increased inspiratory oxygen fraction in able-bodied controls as well as in persons with paraplegia and to a lesser extent in persons with tetraplegia, indicating that peak oxygen consumption during arm exercise is limited by oxygen supply rather than by the small muscle mass and related biochemical limitations.

Adult↗