Avoidant and dependent personality traits in relatives of patients with panic disorder, patients with dependent personality disorder, and normal controls

Psychiatric researchers have long wondered whether personality traits might predispose toward or be integral to Axis I illnesses. The question is difficult to address because acute illness can either create personality traits or distort their measurement. The present study bypassed that problem by examining personality traits in relatives of patients. Panic disorder, dependent personality disorder, and control subjects were the proband groups. A cluster of traits that appeared to reflect low social self-confidence combined with a desire for social interaction occurred significantly more often in relatives of patients in both groups.

The rural route to success. Comparing EMS in three Alabama counties

Why do volunteer EMS systems in otherwise healthy economic communities fail, while other communities, with low per-capita incomes, enjoy thriving volunteer services? This article studies three volunteer systems in rural Alabama to determine the keys to success.

The prognostic significance of HPA-axis disturbance in panic disorder: a three-year follow-up

Seventy-seven patients with DSM-III panic disorder underwent a baseline dexamethasone suppression test (DST), participated in an 8-week controlled treatment trial, and provided follow-up interviews 2-4 years later. The 20 patients who had exhibited DST nonsuppression at baseline had more symptoms of anxiety, more work and social disability, and a greater likelihood of ongoing major depression than did patients who had had normal DST results. DST nonsuppression in panic disorder apparently indicates a more persistent and chronically disabling condition.

Evaluation of restriction endonuclease cleavage of plant nuclear DNA using contaminating chloroplast DNA

Plant DNA is often contaminated by chloroplast DNA. The contamination was used here with advantage to check restriction endonuclease cleavage of plant DNA. This method is based on hybridization of Southern blots of digested plant DNA with cloned fragments of chloroplast DNA as a probe. Advantages of this method are demonstrated.

Relationship between DSM-III avoidant and dependent personality disorders

Avoidant personality disorder was added to the nomenclature in DSM-III without a clinical tradition or empirical findings. This report reviews four attempts to validate empirical personality disorders and presents new data. No empirical study has been successful in differentiating avoidant from dependent personality disorders. The current study replicates this overlap, finding only minor differences (dependent personality disorder had more females, avoidant personality disorder had more self-defeating traits). Avoidant and dependent personality disorders should be merged into an enlarged category of dependent personality disorder, which would have three subtypes: avoidant, dependent, and mixed.

The effect of personality on placebo response in panic patients

Twenty-eight patients who participated as a placebo group in a treatment study of panic disorder were studied to determine the effect of personality on study completion and outcome. Those subjects who completed only 3 weeks had significantly more pathological personality traits than those who continued in the study. For those continuing beyond 3 weeks, there were negative correlations between the paranoid and borderline personality traits and a global outcome measure. Spontaneous panic attacks were not affected by personality.

Outcome of panic disorder. Relationship to diagnostic subtypes and comorbidity

Eighty-nine subjects with panic disorder, who had been naturalistically treated, and 46 nonanxious controls were followed up after 3 years. Although they remained symptomatic, most subjects with panic disorder reported relatively little distress or social maladjustment. The course of panic disorder was characterized by fluctuating anxiety and depressive symptoms. Panic subtypes (uncomplicated, limited phobic avoidance, and extensive phobic avoidance) and Axis I and II comorbidity (major depression and personality disorders) were highly predictive of symptoms and social adjustment after 3 years. Abnormal personality was, in fact, the strongest predictor of social maladjustment in both subjects with panic disorder and controls. The results showed that while panic disorder has a favorable outcome, the illness is a chronic one that may require continuing treatment. They also show that subtypes and comorbid disturbances are important predictors of outcome.

Mental efficiency and hypoglycemia

Cognitive functioning after a mild hypoglycemic episode (MHE) was studied in 24 school-age children with insulin-dependent diabetes mellitus (IDDM). All children were administered a battery of neuropsychological tests which included digit spans, trailmaking tasks, Klove Mathews Maze test, and finger-tapping and handwriting tasks. The experimental group (n = 14) consisted of children who were tested initially after resolution of hypoglycemic symptoms following a documented MHE (Chemstrip bG less than or equal to 60 mg/dl with symptoms). The comparative group (n = 10) consisted of children who were initially evaluated after documentation of euglycemia. Comparison of the comparative group scores with test scores of the experimental group after recovery from the MHE demonstrated statistically significant differences (p less than 0.05 by dependent t-tests) in five of 12 tasks. No differences were noted when second trial scores of both groups were compared when they were retested after documentation of euglycemia. This study suggests that a discrepancy exists between the recovery rate of physical symptoms and cognitive function in children following a MHE.

Nucleotide composition bias and CpG dinucleotide content in the genomes of HIV and HTLV 1/2

Nucleotide compositions of the HIV subfamily and HTLV 1/2 genomes are strongly biased in a remarkably opposite way; HIV is adenine-rich and cytosine-poor while HTLV 1/2 is cytosine-rich and adenine-poor. In addition, the CpG dinucleotides are underrepresented in HIV but abundant in HTLV 1/2. By these two properties the genomes of HIV and HTLV 1/2 mimic an (A + T)-rich and (G + C)-rich segment of the host genome, respectively. These dramatic differences between the two human retroviruses might have evolved to direct integration of the retroviral genomes into specific segments of the human chromosomes.

Validity of criteria for DSM-III self-defeating personality disorder

Criteria for self-defeating personality disorder were examined using a standard measure in 148 psychiatric outpatients. The best individual criterion was self-defeating B (taken advantage of by others). Self-defeating A (sacrifices needs for others) and K (being hurt is sexually arousing) were of little value. Although some dependent, histronic, and avoidant criteria were also related to self-defeating personality disorder, the disorders appeared fairly clearly separate. There did appear to be more overlap (although not identity) with borderline personality disorder. It appears possible that in some circumstances self-defeating personality disorder might be diagnosed using two criteria.

A BamHI family of highly repeated DNA sequences of Nicotiana tabacum

HRS60.1, a monomer unit (184 bp) of a highly repeated nuclear DNA sequence of Nicotiana tabacum, has been cloned and sequenced. Following BamHI digestion of tobacco DNA, Southern hybridization with HRS60.1 revealed a ladder of hybridization bands corresponding to multiples of the basic monomer unit. If the tobacco DNA was digested with restriction endonucleases which have no target site in HRS60.1, the larger part of DNA homologous to HRS60.1 remained as uncleaved "relic" DNA. These results suggest a tandem arrangement of this DNA repeat unit. Four other clones of tobacco nuclear DNA cross-hybridized with HRS60.1, thus forming a "HRS60-family". Sequencing their inserts has shown their strong mutual homology. HRS60-family comprised about 2% of the nuclear genome of N. tabacum. Computer comparisons with other tandem plant-repeated DNA sequences could not detect any other homologous sequence.

Alprazolam treatment of avoidant personality traits in social phobic patients

The authors examined the effect of alprazolam treatment on avoidant personality traits in 14 DSM-III-R social phobics. Six of the nine avoidant traits examined improved with treatment. However, all but one trait (avoiding social or occupational activities requiring interpersonal contact) returned to baseline levels posttreatment. Treatment response and intercorrelation of items indicated two traits that may represent a separate segment of avoidant personality: "No close friends or confidants outside of relatives and family members" and "Exaggerates the potential dangers or risks of everyday situations."

Comorbidity of bulimia nervosa and personality disorder

Thirty patients meeting DSM-III-R criteria for bulimia nervosa with at least three bingeing episodes a week were compared with 30 age- and sex-matched controls on DSM-III personality measures. The bulimic patients were more likely to display cluster B (histrionic, narcissistic, antisocial, and borderline) personality abnormalities (odds ratio 15.0) and cluster C (avoidant, dependent, compulsive, and passive-aggressive) personality abnormalities (odds ratio 4.3) than were the community controls. This study supports the finding that personality disorder is a possible risk factor for bulimia.

Utilization of medical resources in persons with DSM-III personality disorders in a community sample

A community survey of 401 randomly selected subjects yielded 249 responders, of which twenty-six had DSM-III criteria personality disorders (PDs), and 167 had no personality disorder traits (controls). More PDs than controls were medically hospitalized during the last year (38% vs 17%, p = .006). A number of significant associations was found between the number of DSM-III personality trait questions answered in a positive fashion and medical utilization. These associations varied by gender. Most striking was the .50 correlation for females between flamboyant personality disorder scores and visits to the family doctor for mental health reasons.

Prevalence of DSM-III personality disorders in the community

A community sample of adults with a standardized DSM-III, Axis II self-report instrument yielded an age adjusted community prevalence of 11.1% of DSM-III personality disorders. When those with personality disorders (PDs) (n = 26) were compared to those without personality traits (n = 167) the PD group had less education 14.9 (3.0) years vs 16.5 (3.3) years, p = 0.02) and a greater percentage with difficulty with alcohol (19% vs 0.6%, p = 0.0001). Of those married, more PDs reported marital difficulties (29% vs 3.5%, p = 0.002). There was a trend for the PD group to have longer unemployment (p = 0.07).

Frequency of DSM-III personality disorders in patients with panic disorder: comparison with psychiatric and normal control subjects

Three clinical populations--panic disorder (n = 88), randomly selected outpatients (n = 82), and normal control subjects (n = 40)--were compared on three standardized DSM-III personality disorder instruments, the Structured Interview for DSM-III Personality Disorders (SIDP), the Millon Clinical Multiaxial Inventory (MCMI), and the Personality Diagnostic Questionnaire (PDQ). Significant differences were consistently found in presence of "any" personality disorder and DSM-III Cluster C (there were always more disorders in the outpatients). Logistic regression analysis revealed the important determinants predicting personality disorders, and therefore of differences between groups, were state depression, age, lifetime history of alcohol abuse, and presence of panic disorder.

Anxiety symptoms distinguishing social phobia from panic and generalized anxiety disorders

Social phobic (N = 14), generalized anxiety disorder (N = 18), and panic disorder patients (N = 48) were compared on four categories of anxiety symptoms: autonomic hyperactivity, muscular tension, vigilance, and apprehensive expectation. Six specific symptoms (palpitations, chest pains, tinnitus, blurred vision, headaches, fear of dying, and dry mouth) distinguished social phobia from panic disorder, while four (headaches, fear of dying, sweating, and dyspnea) distinguished social phobia from generalized anxiety disorder. Most symptom differences were in the autonomic hyperactivity category of symptoms. These findings further confirm the validity of social phobia as a distinct disorder and may help provide specific target symptoms for the treatment of related but different anxiety disorders.

Age and sex distribution of DSM-III personality cluster traits in a community population

DSM-III pathological personality cluster traits were measured on a community sample of 235 people. Traits in the schizoid cluster (schizoid, schizotypal, and paranoid) showed no change with age while traits in the dramatic cluster (antisocial, narcissistic, borderline, and histrionic) and to some extent the anxious cluster (avoidant, dependent, compulsive, and passive/aggressive) showed similar significant associations with age. This pattern was a reverse "J" shaped curve, with mean number of traits declining from younger to older groups and a slight upturn in the oldest age group (60 years plus). Women aged 31 to 40 years had a higher mean number of traits than their male counterparts, with a corresponding increase in impairment. The highest levels of personality traits in men were found at ages 18 to 30, while in women the 31 to 40 year group was highest.

Comparison of DSM-III personality disorders in recovered depressed and panic disorder patients

A previous report using non-DSM-III measures indicated that recovered panic disorder and recovered major depressive patients have similar personality traits. To replicate this finding on DSM-III measures, 57 recovered panic, 19 recovered depressed, and 40 normal subjects were compared on standardized DSM-III personality measures. Virtually no differences were found between recovered major depression and recovered panic disorder patients. However, these two groups did differ from normal subjects in that they were more socially insecure and dependent.