Replicating the five factor model of personality in a psychiatric sample

Are there gender differences in major depression and its response to antidepressants?

BACKGROUND

The prevalence of major depression for women is about twice that for men. This gender difference in prevalence rates has led to much research addressing gender differences in the presentation and features of major depression, and, to a lesser extent, research addressing gender differences in treatment response and personality. However, studies differ considerably in the population sampled, and findings vary significantly. In the current retrospective examination of data, we investigated all of these variables in one single sample of outpatients with major depression seen in a tertiary care centre.

METHODS

A sample of 139 men and 246 women with major depression receiving antidepressant treatment (SSRIs, TCAs, SNRIs, MAOIs, or RIMAs) in an outpatient setting were contrasted with regard to symptoms and severity of depression, course of illness, treatment response, and personality.

RESULTS

Women were found to experience more vegetative and atypical symptoms, anxiety, and anger than men, and to report higher severity of depression on self-report measures. Regarding personality, women scored higher on conscientiousness, the extraversion facet warmth, the openness facet feelings, and sociotropy. Effect sizes were small to moderate. No differences were found in the course of the illness and treatment response.

LIMITATIONS

Findings are not generalizable to inpatient or community samples, and some of the gender differences may be accounted for by gender differences in treatment seeking behaviour.

CONCLUSIONS

While men and women receiving antidepressant treatment show some gender differences in the psychopathology of major depression, these differences do not appear to translate into differences in response to antidepressants. Gender differences in personality appear less profound than in the average population, indicating the potential role of a certain personality type that predisposes individuals to develop clinical depression, independent of gender.

CLINICAL RELEVANCE

The current examination underscores the role gender plays in the presentation and treatment of major depression.

Personality and psychopathology: working toward the bigger picture

There are systematic and meaningful links among normal and abnormal personality traits and Axis I and II constructs from the DSM. Nevertheless, much research in this area focuses on pairs of constructs (e.g., the link between personality traits and a specific Axis I disorder), rather than on the broader multivariate structure of the personality-psychopathology domain. We underscore the need for this broader perspective, a perspective that would transcend largely artificial boundaries between current constructs (e.g., normal and abnormal personality). We outline our approach to research from this perspective and we emphasize the internalizing (mood and anxiety) and externalizing (substance use and antisocial behavior) spectra as promising foci for initial research on the joint structure of personality and psychopathology.

Cross-cultural replication of the five-factor model and comparison of the NEO-PI-R and MMPI-2 PSY-5 scales in a Dutch psychiatric sample

The authors investigated cross-cultural replicability of the five-factor model (FFM) of personality as represented by the revised NEO Personality Inventory (NEO-PI-R; P. T. Costa & R. R. McCrae, 1992) in a sample of 423 Dutch psychiatric patients. Also, NEO-PI-R domain scales were compared with the Personality Psychopathology Five (PSY-5; A. R. Harkness & J. L. McNulty, 1994) scales of the Minnesota Multiphasic Personality Inventory-2 (J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 2002). Principal-components analysis with procrustean rotation confirmed the hypothesized structural similarity of the present sample with the U.S. normative factor scores. All of the hypothesized relations between NEO-PI-R and PSY-5 scales were confirmed. The results provide evidence for cross-cultural replicability of the FFM and for validity of the NEO-PI-R and PSY-5 constructs in the psychological assessment of psychiatric patients.

Caregiver burden in recent-onset schizophrenia and spectrum disorders: the influence of symptoms and personality traits

Earlier studies that used two symptom dimensions indicate that the caregiver burden for patients with schizophrenia is significantly determined by their negative symptoms. The purpose of this study is to examine the relationship between symptom severity in recent-onset schizophrenia and caregiver burden in a more differentiated way (i.e., five-symptom dimensions). Based on previous research, which shows that patients' personality traits influence the course of schizophrenia, we theorize that personality traits could also influence caregiver burden. So far, this hypothesis has never been studied. Therefore, the second purpose of this study is to examine whether patients' personality traits would contribute to caregiver burden. The results of this study showed that the disorganization symptom component was the predicting variable of the subscales supervision, tension, urging, distress, and the overall amount of caregiver burden in a linear regression analysis. Personality traits of patients played no substantial role in caregiver burden. These findings suggest that psychoeducational programs should address the severity of disorganization symptoms to reduce caregiver burden in the early phase of schizophrenia.

Avoidant personality disorder: current status and future directions

Avoidant Personality Disorder (APD) is the topic of a growing body of research literature. In this article, we review empirical studies of APD with the goals of identifying the themes that underlie this work and pointing to new directions for future research. In particular, we recommend that future studies evaluate several unique factors postulated by personality theorists to be central to this condition.

Conduct disorder: a biopsychosocial review

OBJECTIVE

To review published works on the epidemiology, risk factors, protective factors, typologies, and genetic aspects of conduct disorder (CD).

METHOD

Findings from refereed journal articles and current texts in the field are briefly summarized.

RESULTS

CD is commonly encountered in clinical practice. Factors strongly predictive of future delinquency include past offenses, antisocial peers, impoverished social ties, early substance use, male sex, and antisocial parents. Factors that moderately predict recidivism include early aggression, low socioeconomic status (SES), psychological variables such as risk taking and impulsivity, poor parent-child relationships, poor academic performance, early medical insult, and neuropsychological variables such as poor verbal IQ. Mildly predictive variables include other family characteristics such as large family size, family stress, discord, broken home, and abusive parenting, particularly neglect. Protective factors include individual factors such as skill competence (in social and other arenas), adult relationships, prosocial and proeducational values, and strong social programs and supports.

CONCLUSIONS

We know a great deal about psychosocial risk factors for CD. Some research into protective factors and genetic contributions exists but is in its early stages. Future work will increase our knowledge about subtypes, developmental pathways, and CD treatment.

Effectiveness of NEO-PI-R research validity scales for discriminating analog malingering and genuine psychopathology

We investigated the research validity scales for the NEO Personality Inventory-Revised (NEO-PI-R) proposed by Schinka, Kinder, and Kremer (1997): Positive Presentation Management (PPM) and Negative Presentation Management (NPM). Additionally, an experimental analog to the Minnesota Multiphasic Personality Inventory-2's (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) F-K index was calculated by subtracting the raw score on PPM from the raw score on NPM (NPM-PPM). In 2 studies, all indexes showed significant between-group differences when samples of analog malingerers (n = 97) were contrasted with psychiatric outpatients (n = 272). The sensitivity and specificity of these validity indexes indicated that although none performed well in extremely low base rate environments, the NPM and NPM-PPM indexes showed promise when the base rate of faking bad rose to higher levels.

Response style and the revised NEO personality inventory: validity scales and spousal ratings in a Chinese psychiatric sample

The effects of response style bias on profile scores from the family of NEO scales and the resultant influence of response style on the predictive capacity of these scales continues to be debated. In this study, a large sample of Chinese psychiatric patients were categorized into four response style groups based on their scores from recently developed "validity" scales for the revised NEO Personality Inventory (NEO PI-R). Mean differences and correlations between self-report and spousal ratings of these patients were examined for the NEO PI-R domain and facet scales. Excessive positive self-presentation bias resulted in mean differences between the self-report and spousal ratings for N and E. Correlations between self-report and spousal ratings were reduced in patients engaging in positive self-presentational bias compared to those who were not so categorized on three of the five NEO PI-R scales. However, these results were manifest only in a sub-sample of psychotic patients. Negative self-presentational bias did not affect mean differences or diminish the correlations between the self-report and spousal ratings.

Selective alteration of personality in response to noradrenergic and serotonergic antidepressant medication in depressed sample: evidence of non-specificity

Recent investigations suggest that serotonergic mechanisms modulate dimensions of personality, in particular decreases in Anger-Hostility and increases in Affiliation. None of these studies, however, demonstrated a specific serotonergic effect on personality, as other neurotransmitter systems have not been assessed for their impact on these personality dimensions. In this study, 76 depressed outpatients were treated with either the noradrenergic antidepressant desipramine (n = 38) or a selective serotonin re-uptake inhibitor (paroxetine or sertraline) (n = 38) over a period of 8-14 weeks. Personality scores were measured pre- and post-treatment using the revised NEO Personality Inventory, which measures five basic dimensions of personality, with subscales assessing Anger-Hostility and Affiliation (Gregariousness). There was a significant decrease in Neuroticism and Anger-Hostility, and a significant increase in Extraversion and Gregariousness following antidepressant treatment. Although changes in neuroticism and extraversion were significantly correlated with change in depression severity, Anger-Hostility and Gregariousness personality scores were not. Therefore, changes in these personality traits were not attributable to a non-specific effect of medication on changes in depression severity. There were no significant differences in personality change scores between the antidepressant treatment groups. Thus, while antidepressants may have a direct effect on neurochemical pathways relevant to personality, independent of changes in depression severity, these effects cannot be directly or specifically attributed to a serotonergic mechanism.