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Edler JS, Manz K, Rojas-Perilla N, Baumeister H, Cohrdes C. The role of personality traits and social support in relations of health-related behaviours and depressive symptoms. BMC Psychiatry 2022; 22:52. [PMID: 35065643 PMCID: PMC8784003 DOI: 10.1186/s12888-022-03693-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/29/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Previous evidence has suggested that physically inactive individuals and extensive media users are at high risk for experiencing depressive symptoms. We examined personality traits and perceived social support as potential moderators of this association. Personality and perceived social support were included as two of the most frequently considered variables when determining predispositioning factors for media use phenomena also discussed in relation to physical activity. METHODS We analysed cross-sectional data from 1402 adults (18-31 years old) who participated in a national health survey in Germany (KiGGS, Study on the health of children and adolescents in Germany, wave 2). The data included one-week accelerometer assessments as objective indicators of physical activity, self-reported media use, depressive symptoms, perceived social support and Big 5 personality traits. An elastic net regression model was fit with depressive symptoms as outcome. Ten-fold cross-validation was implemented. RESULTS Amongst the main effects, we found that high media use was positively correlated with depressive symptoms, whereas physical activity was not correlated. Looking at support and individual differences as moderators, revealed that PC use was more strongly correlated with depressive symptoms in cases of low levels of perceived social support. Positive associations of social media use with depressive symptoms were more pronounced, whereas negative associations of moderate to vigorous physical activity with depressive symptoms were less pronounced in extraverts than they were in introverts. CONCLUSIONS Results highlight the importance of considering individual factors for deriving more valid recommendations on protective health behaviours.
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Affiliation(s)
- Johanna-Sophie Edler
- Mental Health Research Unit, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Unit 26 Mental Health, PO Box 650261, 13302, Berlin, Germany.
| | - Kristin Manz
- Physical Health Research Unit, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Natalia Rojas-Perilla
- Department of Analytics in the Digital Era, United Arab Emirates University, Al Ain, UAE
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Caroline Cohrdes
- Mental Health Research Unit, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Unit 26 Mental Health, PO Box 650261, 13302, Berlin, Germany
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Nobre P, Rosa PJ, Vasconcelos P, Tavares I, Carvalho J, Quinta-Gomes A, Moura C, Carrito M. Sexual Health and the Pandemic Crisis: Testing the Role of Psychological Vulnerability/Protective Factors on Sexual Functioning and Sexual Distress During a Critical Life Period in Portugal. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:169-181. [PMID: 35028806 PMCID: PMC8757627 DOI: 10.1007/s10508-021-02209-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 09/15/2021] [Accepted: 10/25/2021] [Indexed: 05/31/2023]
Abstract
Recent findings suggest that the current COVID-19 pandemic has a potential negative impact in several areas of life, including sexual health. However, less is known about the psychological dimensions that may work as vulnerability/protective factors for the development of sexual problems in the current pandemic. The current study used a longitudinal design to examine the role played by personality trait factors (neuroticism, extraversion) as well as psychosexual factors (sexual beliefs) in predicting sexual functioning and sexual distress across time during the current pandemic crisis. A total of 528 individuals (337 women) completed a web survey assessing sexual health indicators and psychological factors. The first wave was conducted during the confinement period in Portugal (N = 528) between May and June 2020 and the second four months later (N = 146), when strict confinement rules were over. Generalized estimating equations (GEE) were used to examine the ability of psychological factors to predict sexual functioning and distress across time, while controlling for age and gender. Results indicated that sexual distress at time point 2 was lower than during confinement, and men had lower levels of sexual functioning post-confinement while no significant difference was observed for women. Moreover, higher levels of neuroticism and age-related beliefs significantly predicted lower sexual functioning as well as higher sexual distress, whereas lower levels of extraversion predicted lower sexual functioning after controlling for age and gender effects. Findings support the role of psychological vulnerability factors to predict sexual problems across time and may have important implications in the prevention and treatment of sexual dysfunctions.
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Affiliation(s)
- Pedro Nobre
- Faculty of Psychology and Educational Sciences, Center for Psychology at University of Porto, University of Porto, 4200-135, Porto, Portugal.
| | - Pedro J Rosa
- Lusófona University, Digital Human-Environment Interaction Lab, Lisbon, Portugal
- ISMAT, Transdisciplinary Research Center (ISHIP), Portimão, Portugal
| | - Priscila Vasconcelos
- Faculty of Psychology and Educational Sciences, Center for Psychology at University of Porto, University of Porto, 4200-135, Porto, Portugal
| | - Inês Tavares
- Faculty of Psychology and Educational Sciences, Center for Psychology at University of Porto, University of Porto, 4200-135, Porto, Portugal
| | - Joana Carvalho
- Faculty of Psychology and Educational Sciences, Center for Psychology at University of Porto, University of Porto, 4200-135, Porto, Portugal
| | - Ana Quinta-Gomes
- Faculty of Psychology and Educational Sciences, Center for Psychology at University of Porto, University of Porto, 4200-135, Porto, Portugal
| | - Catarina Moura
- Faculty of Psychology and Educational Sciences, Center for Psychology at University of Porto, University of Porto, 4200-135, Porto, Portugal
| | - Mariana Carrito
- Faculty of Psychology and Educational Sciences, Center for Psychology at University of Porto, University of Porto, 4200-135, Porto, Portugal
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Psychological risk factors and the course of depression and anxiety disorders: A review of 15 years NESDA research. J Affect Disord 2021; 295:1347-1359. [PMID: 34706448 DOI: 10.1016/j.jad.2021.08.086] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Netherlands Study of Depression and Anxiety (NESDA; Nbaseline=2981) is an ongoing longitudinal, multi-site, naturalistic, cohort study examining the etiology, course, and consequences of depression and anxiety. In this article we synthesize and evaluate fifteen years of NESDA research on prominent psychological risk factors for the onset, persistence, recurrence, and comorbidity of affective disorders. METHODS A narrative review of 62 NESDA articles examining the specificity and predictive value of neuroticism, behavioral inhibition, repetitive negative thinking, experiential avoidance, cognitive reactivity, locus of control, (implicit) self-esteem, (implicit) disorder-specific self-associations, and attentional bias for the course of affective disorders. RESULTS All self-reported risk factors showed cross-sectional relationships with singular and comorbid affective disorders, and prospective relationships with the development and chronicity of depression and anxiety disorders. High neuroticism, low self-esteem, and negative repetitive thinking showed most prominent transdiagnostic relationships, whereas cognitive reactivity showed most pronounced depression-specific associations. Implicit self-esteem showed predictive validity for the persistence and recurrence of anxiety and depression over and above self-reported risk factors. Automatic approach-avoidance behavior and attentional bias for negative, positive, or threat words showed no relationship with affective disorders. CONCLUSION NESDA identified both (a) transdiagnostic factors (e.g., neuroticism, low implicit self-esteem, repetitive negative thinking) that may help explain the comorbidity between affective disorders and overlap in symptoms, and (b) indications for disorder-specific risk factors (e.g., cognitive responsivity) which support the relevance of distinct disorder categories and disorder-specific mechanisms. Thus, the results point to the relevance of both transdiagnostic and disorder-specific targets for therapeutic interventions.
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Ka L, R E, K W, G J, Lje B. Associations between Facets and Aspects of Big Five Personality and Affective Disorders:A Systematic Review and Best Evidence Synthesis. J Affect Disord 2021; 288:175-188. [PMID: 33901698 DOI: 10.1016/j.jad.2021.03.061] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 03/03/2021] [Accepted: 03/19/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Big Five personality traits correlate with affective disorders, with neuroticism considered a risk factor, and conscientiousness and extroversion considered protective factors. However, the relationships between affective disorders and lower-order personality facets and aspects are less clear. METHOD A systematic review was carried out to identify studies measuring associations between lower-order personality constructs and affective disorders. Big Five facets were measured using the NEO-PI-R, and aspects using the BFAS. PsycINFO, EMBASE, MedLine and OpenGrey were searched from January 1st, 1985 to June 30th, 2020. Fifteen studies met criteria and reported a total of 408 associations. Data were analysed using best evidence synthesis. RESULTS Most facets of neuroticism were positively associated with affective disorders. Positive emotion in extroversion, and competence and self-discipline in conscientiousness, were negatively associated with affective disorders. Trust in agreeableness, and actions in openness, were negatively associated with anxiety disorders, whereas fantasy in openness was positively associated with anxiety disorders. At the aspect level, withdrawal in neuroticism was positively associated with MDD, whereas industriousness in conscientiousness was negatively associated with MDD. LIMITATIONS Due to the use the heterogenous measures between studies, a meta-analysis could not be performed. Only Big Five personality constructs were investigated, limited to BFAS personality aspects, and NEO-PI-R personality facets. CONCLUSIONS Neuroticism, positive emotion, competence and self-discipline correlate with various anxiety and depressive disorders. These facets may be endophenotypes for affective disorders in general. Future research is needed to investigate mediating pathways between personality facets and affective disorders.
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Affiliation(s)
- Lyon Ka
- Division of Neuroscience and Experimental Psychology, University of Manchester, M13 9PG.
| | - Elliott R
- Division of Neuroscience and Experimental Psychology, University of Manchester, M13 9PG
| | - Ware K
- Division of Psychology and Mental Health, University of Manchester, M13 9PL
| | - Juhasz G
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary; SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
| | - Brown Lje
- Division of Psychology and Mental Health, University of Manchester, M13 9PL
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The dual-system theory of bipolar spectrum disorders: A meta-analysis. Clin Psychol Rev 2020; 83:101945. [PMID: 33217713 DOI: 10.1016/j.cpr.2020.101945] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 10/15/2020] [Accepted: 11/02/2020] [Indexed: 01/05/2023]
Abstract
Bipolar spectrum disorders are characterized by alternating intervals of extreme positive and negative affect. We performed a meta-analysis to test the hypothesis that such disorders would be related to dysregulated reinforcement sensitivity. First, we reviewed 23 studies that reported the correlation between self-report measures of (hypo)manic personality and measures of reinforcement sensitivity. A large relationship was found between (hypo)manic personality and BAS sensitivity (g = .74), but not with BIS sensitivity (g = -.08). This stands in contrast to self-reported depression which has a small, negative relationship with BAS sensitivity and a large positive one with BIS sensitivity (Katz et al., 2020). Next, we reviewed 33 studies that compared reinforcement sensitivity between euthymic, bipolar participants and healthy controls. There, bipolar disorder had a small, positive relationship with BAS sensitivity (g = .20) and a medium, positive relationship with BIS sensitivity (g = .64). These findings support a dualsystem theory of bipolar disorders, wherein BAS sensitivity is more closely related to mania and BIS sensitivity more closely to bipolar depression. Bipolar disorders show diatheses for both states with euthymic participants being BAS- and BIS- hypersensitive. Implications for further theory and research practice are expounded upon in the discussion.
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Peri JM, Muñoz-Champel A, Torrubia R, Gutiérrez F. The General Criteria for Personality Disorders Assessed by Interview: Do They Still Have a Role to Play? J Pers Disord 2019; 33:515-S9. [PMID: 30307831 DOI: 10.1521/pedi_2018_32_356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
On the path to developing dimensional models of personality disorder (PD), we are at risk of leaving key diagnostic aspects behind. The general criteria for PD may be important ones because they reflect the defining aspects of personality pathology: long duration, independence from psychopathological states, and harmfulness. We assessed these criteria by interview in a sample of 362 psychiatric outpatients after administering the Personality Diagnostic Questionnaire-4+. The result was a 42.5% fall in self-reported endorsements, due to misinterpretations (11.5%), short duration of traits or contamination by state psychopathology (9.8%), and traits being non-harmful (21.2%). However, not all personality traits and disorders underwent correction to the same extent, and ultimately, the interview did not improve the prediction of clinical variables. These findings raise doubts about the practical relevance of the general criteria for PD and support the role of self-report questionnaires for diagnostic purposes.
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Affiliation(s)
- Josep M Peri
- Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ana Muñoz-Champel
- Department of Legal Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona
| | - Rafael Torrubia
- Department of Legal Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona
| | - Fernando Gutiérrez
- Personality Disorder Unit, Institute of Neuroscience, Hospital Clínic de Barcelona, and Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Barcelona
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van Eeden WA, van Hemert AM, Carlier IVE, Penninx BW, Spinhoven P, Giltay EJ. Neuroticism and chronicity as predictors of 9-year course of individual depressive symptoms. J Affect Disord 2019; 252:484-492. [PMID: 31005791 DOI: 10.1016/j.jad.2019.04.052] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/31/2019] [Accepted: 04/08/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND The large between-person differences in symptomatology suggest that major depressive disorder (MDD) is a heterogeneous psychiatric disorder. However, symptom-specific prospective studies are scarce. We hypothesized that chronicity (i.e., being depressed for 24 months during a patient's preceding 48 months at baseline) and neuroticism at baseline would predict adverse course trajectories over 9 years of follow up with differential magnitudes for individual depressive symptoms. METHODS In total, 560 patients with a current MDD were included from the Netherlands Study of Depression and Anxiety (NESDA-cohort). We used a multivariate linear mixed model with repeated measures, with a history of chronicity and neuroticism separately as main independent variables and with Inventory of Depressive Symptomatology self-report (IDS-SR) item scores as outcome variables. For each individual symptom, the model was adjusted for age, gender, and baseline depression severity. RESULTS Patients were on average 42.7 (SD = 12.1) years old and 64.7% were women. Patients with chronic depression or high levels of neuroticism showed similar absolute rates of decline over time compared to their counterparts. However, because symptoms had higher starting points for mood, cognitive, and somatic/vegetative symptoms (in that order), symptom severity remained higher over time. Chronicity and neuroticism were especially linked to persistent low self-esteem and high interpersonal sensitivity. LIMITATIONS Neuroticism is partly state dependent and likely affected by depression severity. CONCLUSIONS Chronicity and neuroticism predict long-term persistence of diverse psychiatric symptoms, in particular low self-esteem and high interpersonal sensitivity.
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Affiliation(s)
- Wessel A van Eeden
- Department of Psychiatry, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands.
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
| | - Ingrid V E Carlier
- Department of Psychiatry, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
| | - Brenda W Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, VU University Medical Center, and GGZ inGeest, Amsterdam, the Netherlands
| | - Philip Spinhoven
- Department of Psychiatry, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands; Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, the Netherlands
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Struijs SY, Lamers F, Spinhoven P, van der Does W, Penninx BWJH. The predictive specificity of psychological vulnerability markers for the course of affective disorders. J Psychiatr Res 2018; 103:10-17. [PMID: 29758471 DOI: 10.1016/j.jpsychires.2018.04.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/05/2018] [Accepted: 04/25/2018] [Indexed: 10/17/2022]
Abstract
High scores on markers of psychological vulnerability have been associated with a worse course of affective disorders. However, little is known about the specificity of those associations in predicting the course of different depressive and anxiety disorders. We examined the impact of psychological vulnerability on the short- and long-term course of depressive and anxiety disorders. Participants from the Netherlands Study of Depression and Anxiety with a current diagnosis of depression or anxiety (n = 1256) were reassessed after 2 and 6 years. Diagnostic status and chronic duration (>85% of the time) of symptoms were the outcomes. Predictors were neuroticism, extraversion, locus of control, cognitive reactivity (rumination and hopelessness reactivity), worry and anxiety sensitivity. High neuroticism, low extraversion and external locus of control predicted chronicity of various affective disorders. Rumination, however, predicted chronicity of depressive but not anxiety disorders. Worry specifically predicted chronicity of GAD and anxiety sensitivity predicted chronicity of panic disorder and social anxiety disorder. These patterns were present both at short-term and at long-term, without losing predictive accuracy. Psychological vulnerabilities that are theoretically specific to certain disorders indeed selectively predict the course of these disorders. General markers of vulnerability predicted the course of multiple affective disorders. This pattern of results supports the notion of specific as well as transdiagnostic predictors of the course of affective disorders and is consistent with hierarchical models of psychopathology.
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Affiliation(s)
- Sascha Y Struijs
- Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Center, 1081 HJ Amsterdam, The Netherlands.
| | - Femke Lamers
- Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Center, 1081 HJ Amsterdam, The Netherlands
| | - Philip Spinhoven
- Institute of Psychology, Leiden University, 2333 AK Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Centre, 2333 ZA, The Netherlands
| | - Willem van der Does
- Institute of Psychology, Leiden University, 2333 AK Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Centre, 2333 ZA, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry and Amsterdam Public Health Research Institute, VU University Medical Center, 1081 HJ Amsterdam, The Netherlands
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Spinhoven P, Elzinga BM, Van Hemert AM, de Rooij M, Penninx BW. Childhood maltreatment, maladaptive personality types and level and course of psychological distress: A six-year longitudinal study. J Affect Disord 2016; 191:100-8. [PMID: 26655119 DOI: 10.1016/j.jad.2015.11.036] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 11/18/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Childhood maltreatment and maladaptive personality are both cross-sectionally associated with psychological distress. It is unknown whether childhood maltreatment affects the level and longitudinal course of psychological distress in adults and to what extent this effect is mediated by maladaptive personality. METHODS A sample of 2947 adults aged 18-65, consisting of healthy controls, persons with a prior history or current episode of depressive and/or anxiety disorders according to the Composite Interview Diagnostic Instrument were assessed in six waves at baseline (T0) and 1 (T1), 2 (T2), 4 (T4) and 6 years (T6) later. At each wave psychological distress was measured with the Inventory of Depressive Symptomatology, Beck Anxiety Inventory, and Fear Questionnaire. At T0 childhood maltreatment types were measured with a semi-structured interview (Childhood Trauma Interview) and personality traits with the NEO-Five Factor Inventory. RESULTS Using latent variable analyses, we found that severity of childhood maltreatment (emotional neglect and abuse in particular) predicted higher initial levels of psychological distress and that this effect was mediated by maladaptive personality types. Differences in trajectories of distress between persons with varying levels of childhood maltreatment remained significant and stable over time. LIMITATIONS Childhood maltreatment was assessed retrospectively and maladaptive personality types and level of psychological distress at study entry were assessed concurrently. CONCLUSIONS Routine assessment of maladaptive personality types and possible childhood emotional maltreatment in persons with severe and prolonged psychological distress seems warranted to identify persons who may need a different or more intensive treatment.
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Affiliation(s)
- Philip Spinhoven
- Section of Clinical Psychology, Leiden University, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
| | - Bernet M Elzinga
- Section of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Albert M Van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark de Rooij
- Section of Methods and Statistics, Leiden University, Leiden, The Netherlands
| | - Brenda W Penninx
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands; Department of Psychiatry/ EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Spinhoven P, Drost J, de Rooij M, van Hemert AM, Penninx BW. A longitudinal study of experiential avoidance in emotional disorders. Behav Ther 2014; 45:840-50. [PMID: 25311292 DOI: 10.1016/j.beth.2014.07.001] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 06/23/2014] [Accepted: 07/01/2014] [Indexed: 11/30/2022]
Abstract
The aim of this study was to examine the degree in which measurements of trait experiential avoidance (EA) are affected by current emotional disorder and whether EA is a causal factor in the course of emotional disorders (anxiety and depressive disorders) and the development of comorbidity among emotional disorders. In a sample of 2,316 adults aged 18 to 65, consisting of healthy controls, persons with a prior history of emotional disorders, and persons with a current emotional disorder, DSM-IV-based emotional disorders (CIDI: Composite Interview Diagnostic Instrument) were assessed at T2 and 2 (T4) and 4years later (T6) and experiential avoidance (AAQ: Acceptance and Action Questionnaire) at T2 and T4. Results showed that EA scores were stable over a 2-year period notwithstanding state fluctuations because of current emotional disorder. Moreover, EA scores at T2 predicted changes in distress (major depressive disorder, dysthymia, generalized anxiety disorder) and in fear disorders (social anxiety disorder, panic disorder with or without agoraphobia, agoraphobia without panic) at T4. Finally, EA at T4 mediated the longitudinal association of fear disorders at T2 with distress disorders at T6 as well as of distress disorders at T2 with fear disorders at T6. These findings suggest that EA scores are more than epiphenomena of emotional disorders and that EA may be conceptualized as a relevant transdiagnostic factor affecting the course and development of comorbidity of emotional disorders.
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Affiliation(s)
| | | | | | | | - Brenda W Penninx
- Leiden University Medical Center, University Medical Center Groningen, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam
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Abstract
PURPOSE OF REVIEW Durability has traditionally been considered to be a defining feature of personality disorders, but recent studies have challenged this notion. We review the most recent findings on the stability and course of personality pathology. RECENT FINDINGS Personality disorders seem to remit more often and faster than previously thought, and their relapse rate is low. However, the recent optimism regarding these disorders is mitigated by the existence of highly heterogeneous trajectories among patients and traits, the identification of certain methodological shortcomings, and the maintenance of psychosocial impairment long after symptomatic relief. The causes of personality improvement are largely unknown, but involve intermingled genetic and environmental effects. SUMMARY Recent follow-up studies of patients with personality pathology are changing orthodox conceptions of their inevitably negative prognosis. The current taxonomies must be reviewed and future research should be integrated with adjacent fields. Treatments need to target the enduring real-life hardships of these patients, apart from their acute symptoms.
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