Big Five personality traits and medically unexplained symptoms in later life

Optimism, Resilience, and General Self-Efficacy Predict Lower Somatic Burden during the COVID-19 Pandemic

There is scarce evidence of a relationship between positive and psychosomatic characteristics. This study aimed to examine the associations of somatic burden with psychological resources such as optimism, resilience, and general self-efficacy. Russian participants (n = 1020) completed measures of psychological resources at Time 1 and somatic symptoms at Time 2. The results showed that somatic burden decreased with greater levels of optimism, resilience, and general self-efficacy. Regarding health and sociodemographic characteristics, female sex increased somatic burden in the model with optimism scores, university education decreased somatic burden in the model with resilience scores, and history of COVID-19 disease increased somatic burden in the models with optimism, resilience, and general self-efficacy scores. This study has theoretical and practical contributions. It combines positive psychology and psychosomatic medicine and highlights the value of psychological resource interventions in the treatment and prevention of somatic burden. These findings may be useful for scientists, clinicians, and practitioners.

Putting the Vicious Cycle to the Test: Evidence for the Cognitive Behavioral Model of Persistent Somatic Symptoms From an Online Study

OBJECTIVE

In clinical practice, persistent somatic symptoms are regularly explained using a cognitive-behavioral model (CBM). In the CBM, predisposing, perpetuating, and precipitating factors are assumed to interact and to cause the onset and endurance of somatic symptoms. However, these models are rarely investigated in their entirety.

METHODS

We conducted an online survey during the COVID-19 pandemic. A total of 2114 participants from the general German population completed questionnaires that measured different factors of the CBM. We used state negative affectivity and neuroticism as predisposing factors, fear of a COVID-19 infection as the precipitating factor, and somatic symptoms, misinterpretation of bodily symptoms, attention allocation to bodily symptoms, and health anxiety as perpetuating factors. Moreover, we added safety and avoidance behavior as end points to the model. We conducted a psychological network analysis to exploratively study the relationships between the model's different factors and tested the assumptions of the CBM by evaluating a structural equation model (SEM) that incorporated all factors of the model.

RESULTS

Network analyses revealed clustering in our data: Health anxiety and different cognitive factors are closely related, whereas somatic symptoms and state negative affectivity are strongly associated. Our SEM showed adequate fit.

CONCLUSIONS

Our findings from an exploratory and a confirmatory approach give empirical support for the CBM, suggesting it as a suitable model to explain bodily symptoms in the general population and to possibly guide clinical practice. The network model additionally indicates the necessity to apply an individualized CBM for patients, depending on a preponderance of either persistent somatic symptoms or health concerns.

Hypothyroidism and Type D Personality: Results From E-MPATHY, a Cross-sectional International Online Patient Survey

CONTEXT

Between 10% and 15% of people with hypothyroidism experience persistent symptoms, despite achieving biochemical euthyroidism. The underlying causes are unclear. Type D personality (a vulnerability factor for general psychological distress) is associated with poor health status and symptom burden but has not been studied in people with hypothyroidism.

OBJECTIVE

To investigate type D personality in hypothyroidism and explore associations with other characteristics and patient-reported outcomes.

DESIGN

Multinational, cross-sectional survey.

SETTING

Online.

PARTICIPANTS

Individuals with self-reported, treated hypothyroidism.

INTERVENTION

Questionnaire.

MAIN OUTCOME MEASURES

Type D personality and associations with baseline characteristics, control of the symptoms of hypothyroidism by medication, satisfaction with care and treatment of hypothyroidism, impact of hypothyroidism on everyday living.

RESULTS

A total of 3915 responses were received, 3523 of which were valid. The prevalence of type D personality was 54.2%. Statistically significant associations were found between type D personality and several respondent characteristics (age, marital status, ethnicity, household income, comorbidities, type of treatment for hypothyroidism, most recent TSH level), anxiety, depression, somatization, poor control of the symptoms of hypothyroidism by medication, dissatisfaction with care and treatment of hypothyroidism, and a negative impact of hypothyroidism on everyday living).

DISCUSSION

Our study found a high prevalence of type D personality among people with hypothyroidism who responded to the survey. Type D personality may be an important determinant of dissatisfaction with treatment and care among people with hypothyroidism. Our findings require independent confirmation. Close collaboration between the disciplines of thyroidology and psychology is likely to be key in progressing our understanding in this area.

A head-to-head comparison of eight unique personality systems in predicting somatization phenomenon

BACKGROUND

If somatization is an independent personality trait, it is not clear whether it is specific to the temperament or maladaptive spectrum of personality. We aimed at the head-to-head comparison of temperament and maladaptive systems and spectra of personality to predict both somatization and somatic symptom and related disorders (SSRD).

METHODS

The samples included 257 cases with SSRD (70.8% female) and 1007 non-SSRD (64.3% female) from Western Iran. The Personality Inventory for DSM-5 (PID-5), Personality Diagnostic Questionnaire-4 (PDQ-4), Temperament and Character Inventory (TCI), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A), Affective and Emotional Composite Temperament Scale (AFECTS), and Positive Affect and Negative Affect Model (PANAS) was used to data collection. A somatization factor plus temperament and maladaptive spectra of personality were extracted using exploratory factor analysis. Several hierarchical linear and logistic regressions were used to test the predictive systems and spectra.

RESULTS

All personality systems jointly predict both somatization and SSRD with a slightly higher contribution for temperament systems. When the temperament and maladaptive spectra were compared, both spectra above each other significantly predicted both somatization (R2 = .407 versus .263) and SSRD (R2 = .280 versus .211). The temperament spectrum explained more variance beyond the maladaptive spectrum when predicting both the somatization factor (change in R2 = .156 versus .012) and SSRD (change in R2 = .079 versus .010).

CONCLUSION

All temperament and maladaptive frameworks of personality are complementary to predicting both somatization and SSRD. However, the somatization is more related to the temperament than the maladaptive spectrum of personality.

The Relationship between Personality Traits and Compliance with the COVID-19 Preventive Measures in Kosovo

The COVID-19 pandemic urged systematic restrictive measures in order to avoid the spread of the virus. Different countries applied different restrictive measures; however, their efficacy was vastly dependent on the willingness of the people to comply with them. How people perceived the pandemic yielded different adaptive behavior to preventative measures. In this direction, individual characteristics (i.e., personality) seem very important. The current study aimed to map a relationship between personality structure as postulated within the five-factor model of personality with the tendency to comply with preventive measures, as mediated by perceived stress and concerns over coronavirus. In a sample of 3252 adults, we found that the traits of openness, agreeableness, and conscientiousness directly and positively predicted compliance. However, concerns over coronavirus partially but positively mediated the relationship between agreeableness and conscientiousness on compliance. Perceived stress, on the other hand, was not a significant mediator, although it was significantly and positively predicted by neuroticism but negatively by extraversion. These findings showed that different personality traits have different direct effects on compliance with preventative measures.

Identifying Big Five personality traits based on facial behavior analysis

The personality assessment is in high demand in various fields and is becoming increasingly more important in practice. In recent years, with the rapid development of machine learning technology, the integration research of machine learning and psychology has become a new trend. In addition, the technology of automatic personality identification based on facial analysis has become the most advanced research direction in large-scale personality identification technology. This study proposes a method to automatically identify the Big Five personality traits by analyzing the facial movement in ordinary videos. In this study, we collected a total of 82 sample data. First, through the correlation analysis between facial features and personality scores, we found that the points from the right jawline to the chin contour showed a significant negative correlation with agreeableness. Simultaneously, we found that the movements of the left cheek's outer contour points in the high openness group were significantly higher than those in the low openness group. This study used a variety of machine learning algorithms to build the identification model on 70 key points of the face. Among them, the CatBoost regression algorithm has the best performance in the five dimensions, and the correlation coefficients between the model prediction results and the scale evaluation results are about medium correlation (0.37-0.42). Simultaneously, we executed the Split-Half reliability test, and the results showed that the reliability of the experimental method reached a high-reliability standard (0.75-0.96). The experimental results further verify the feasibility and effectiveness of the automatic assessment method of Big Five personality traits based on individual facial video analysis.

Somatization symptoms-prevalence and risk, stress and resilience factors among medical and dental students at a mid-sized German university

Objective

Previous studies have shown that an increased prevalence of mental illness can be found among medical and dental students. Among these, somatization symptoms are severely understudied. The present study examined the prevalence of somatization symptoms in a subpopulation of medical and dental students and aimed at finding associated risk and resilience factors.

Methods

A cross-sectional survey was conducted using a self-reporting questionnaire, including the SOMS-2, the Becks-Depression-Inventory-II (BDI-II), the NEO-Five-Factor-Inventory, and a questionnaire on socio-demographics for possible risk and resilience factors. A total of 271 medical and dental students of a mid-sized German university completed the questionnaire.

Results

The Somatization index yielded a mean of 9.12 symptoms for the total sample, which is 1.2 SD higher than the reported norm. A total of 50.7% of the medical students and 63.6% of the dental students transcend a critical somatization score. Significant positive associations for eight general risk factors, four university related stress factors, and a significant negative association for seven resilience factors were found.

Conclusion

Medical and even more dental students at the studied university showed a high burden of somatoform complaints. Also, factors were found that could be of etiological relevance and others that could be used to enhance resilience. Both could present an opportunity for the prevention of somatization disorders but prospective and multicenter studies with an aged-matched comparison group are needed to obtain a more accurate overview.

The meaning of momentary psychotic-like experiences in a non-clinical sample: A personality perspective

The relationships between Momentary Psychotic-Like Experiences (MPLEs) and HEXACO—complemented by the proneness to PLEs conceptualized as a basic personality trait (Disintegration), and a maladaptive trait (PID-5 Psychoticism)—were investigated in a prospective study that includes experience-sampling methodology (ESM). The main goal was to investigate whether MPLEs are better predicted by HEXACO or measures of the dispositional proneness to PLEs. A sample of 180 participants assessed MPLEs and affective states they experienced in the previous two hours, twice per day, with semi-randomly set assessment time-points, during seven days, by using ESM. Personality inventories were administered 1–2 months earlier. MPLEs were better predicted by the measures of dispositional tendencies toward PLEs than by the HEXACO, no matter whether it was broadly defined as the nine-faceted general tendency toward PLEs (Disintegration), or narrowly as three-faceted positive psychotic-like symptoms of maladaptive personality tendencies (PID-5—Psychoticism).

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): III. Emotional dysfunction superspectrum

The Hierarchical Taxonomy of Psychopathology (HiTOP) is a quantitative nosological system that addresses shortcomings of traditional mental disorder diagnoses, including arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, substantial heterogeneity within disorders, and diagnostic unreliability over time and across clinicians. This paper reviews evidence on the validity and utility of the internalizing and somatoform spectra of HiTOP, which together provide support for an emotional dysfunction superspectrum. These spectra are composed of homogeneous symptom and maladaptive trait dimensions currently subsumed within multiple diagnostic classes, including depressive, anxiety, trauma-related, eating, bipolar, and somatic symptom disorders, as well as sexual dysfunction and aspects of personality disorders. Dimensions falling within the emotional dysfunction superspectrum are broadly linked to individual differences in negative affect/neuroticism. Extensive evidence establishes that dimensions falling within the superspectrum share genetic diatheses, environmental risk factors, cognitive and affective difficulties, neural substrates and biomarkers, childhood temperamental antecedents, and treatment response. The structure of these validators mirrors the quantitative structure of the superspectrum, with some correlates more specific to internalizing or somatoform conditions, and others common to both, thereby underlining the hierarchical structure of the domain. Compared to traditional diagnoses, the internalizing and somatoform spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and greater clinical applicability. Validated measures are currently available to implement the HiTOP system in practice, which can make diagnostic classification more useful, both in research and in the clinic.

Is the Global Pandemic Driving Me Crazy? The Relationship Between Personality Traits, Fear of Missing Out, and Social Media Fatigue During the COVID-19 Pandemic in Nigeria

Individ    uals' psychological behaviors and fear of missing out are affected by the global pandemic. This study investigates how individual "Big Five" personality traits influence fear of missing out leading to social media fatigue, the impact of social media fatigue on social media fatigue behavior during the COVID-19 lockdown. As a result, this study proposes and develops a model using the structural equation modelling for data obtained from young adults in the South-Western region of Nigeria. Results show the impact of openness, conscientiousness, and extraversion emotional instability was positively significant towards fear of missing out over the use of social media during COVID-19, whereas the effect of agreeableness and emotional stability were insignificant towards fear of missing out over the use of social media during COVID-19. In addition, the impact of the fear of missing out on social media fatigue influences social media fatigue behavior. Theoretical and managerial implications for "Big Five" personality traits, fear of missing out, social media fatigue, and social media behaviors are provided.

Personality traits, perceived stress and perception of COVID-19 among Arab Population: A cross-sectional survey

Background

Coronavirus disease-2019 is a worldwide pandemic. Political authorities are working hard to fight the disease transmission through corresponding interventions that may be influenced by individual perception, perceived stress, and personality traits that act as predictors of healthy behaviors and comply with protective measures especially with different cultures.

Aim

This study aimed to assess personality traits, perceived stress, and perception among the Arab population.

Methods

A cross-sectional online survey was fulfilled by 948 adults from different Arabic nationalities from 24th June to 15th July 2020. The Ten-Item Personality Inventory (TIPI), the Perceived Stress Scale (PSS), and Perception toward COVID-19 Questionnaire were used in this study.

Results

More than three quarters (76.1%) believed that COVID 19 is a dangerous disease and the vast majority (93.1%) disagreed that infection with the virus is associated with stigma. Agreeableness was high among the Egyptians, extroversion and openness to experience were high among Saudi Arabians, while emotional stability was high among Sudanese participants.

Conclusion

Individuals with high conscientiousness, extraversion, and emotional stability demonstrated lower levels of perceived stress during the pandemic. This highlights that for the development of stress management interventions during epidemics; it is crucial to take personality traits into consideration.

Somatization and Somatic Symptom Disorder and its overlap with dimensionally measured personality pathology: A systematic review

OBJECTIVE

Difficulties in the assessments of Somatoform Disorders (SD) and Personality Disorders (PD) regarding operationalization, arbitrary thresholds, and reliability led to a shift from categorical to dimensional models in the DSM-5. Empirical research data postulates a continuous level of severity in both groups of diseases. The aim of this systematic review was to investigate the overlap between somatization and personality pathology.

METHODS

Until July 2020, we conducted a systematic literature search with PubMed, Web of Science and SCOPUS. We specifically reviewed current empirical data on the Alternative Model of Personality Disorders (AMPD) and Somatic Symptom Disorder (SSD) and SD. Data was drawn out using predefined data panels. Results were reflected in the context of the Hierarchical Taxonomy of Psychopathology (HiTOP) model. Risk of bias was assessed due to blinding, randomization, selective reporting, incomplete data, and attribution bias.

RESULTS

A total of eight studies (N = 2979) met the inclusion criteria. Whereas categorical measures revealed mixed results, positive correlations between SD/SSD and dimensionally measured personality functioning were present in four studies (N = 1741). In three studies (N = 2025) correlations between SD/SSD and neuroticism/negative affectivity (d = 0.22-1.041) were present. Moreover, harm avoidant (d = 0.526 - 0.826) and self-defeating traits (d = 0.892) revealed significant associations with somatization.

CONCLUSIONS

Dimensional personality assessments are highly neglected in patients with SSD and warrant further research. However, in line with the HiTOP model, there is tentative evidence that somatization can be described as an independent personality trait, which shows most striking overlaps with self-pathologies (Criterion A) and the trait of negative affectivity (Criterion B).

Personality Traits That Affect Travel Intentions during Pandemic COVID-19: The Case Study of Serbia

The pandemic caused by COVID-19 has enormous effects on peoples’ lives and on the global economy. The outbreak and effects of COVID-19 have resulted in fears, concerns, and anxiety among people all around the world. The aim of this study is to investigate the relationship between the fear of COVID-19, travel anxiety, and travel intention among residents in Serbia. In addition to the above, the aim of the study was to examine the impact of personality traits on the fear of COVID-19, travel anxiety, and travel intentions. To enhance the understanding of the relationship between the mentioned variables, this study proposes a research model based on the use of measurement scales from the existing studies to develop the questionnaire. The standard paper-and-pen survey was used for data collection from the respondents from Serbia. The total sample include 987 respondents. It was determined that Travel intention was negatively influenced by Neuroticism and Conscientiousness, but positively by Extroversion and Openness. The supposed Agreeableness did not have a significant effect on Travel intention. This study contributes to understanding the respondents’ behavior during pandemic of COVID-19, and their responses to the crisis according to their personality traits might have practical implications in the travel sector.

Prevalence of Alexithymia in Patients with Medically Unexplained Physical Symptoms: A Cross-sectional Study in Egypt

BACKGROUND

There is a high incidence of alexithymia in people who report medically unexplained symptoms. There have been limited studies on the prevalence of alexithymia in patients with medically unexplained physical symptoms (MUPS) in various ethnic and cultural backgrounds.

OBJECTIVE

This study aimed to estimate the prevalence of alexithymia in patients with MUPS and examine their socio-demographic data.

METHODS

In this cross-sectional study, 196 patients with MUPS were recruited from tertiary care internal medicine and neuropsychiatry clinics during the first quarter of 2019. Patients completed a structured interview; socio-demographic and medical history data were collected. Somatic symptom severity was assessed using the Arabic version of the Patient Health Questionnaire (PHQ-15). Alexithymia was assessed using the Arabic version of the Toronto Alexithymia Scale.

RESULTS

General fatigue was the most common complaint observed, followed by headache and dyspepsia. In addition, 73.5% of patients had a high Patient Health Questionnaire score, 17.9% had somatic symptoms of medium severity, while 8% and 0.5% had low and marginal somatic symptoms, respectively. Alexithymia was presented in 49.5%, 22.9% had no alexithymia, and 27.6% had borderline/intermediate alexithymia.A weak positive correlation (r<0.4) was found between somatic symptom severity and alexithymic psychopathology (r=0.277;p<0.05). Only the 'difficulty identifying feelings' dimension of alexithymic psychopathology was positively correlated with the severity of somatic symptoms (r=0.271;p<0.05).

CONCLUSION

Alexithymia is associated with the development of MUPS.

Stronger connectivity and higher extraversion protect against stress-related deterioration of cognitive functions

Here we attempted to define the relationship between: EEG activity, personality and coping during lockdown. We were in a unique situation since the COVID-19 outbreak interrupted our independent longitudinal study. We already collected a significant amount of data before lockdown. During lockdown, a subgroup of participants willingly continued their engagement in the study. These circumstances provided us with an opportunity to examine the relationship between personality/cognition and brain rhythms in individuals who continued their engagement during lockdown compared to control data collected well before pandemic. The testing consisted of a one-time assessment of personality dimensions and two sessions of EEG recording and deductive reasoning task. Participants were divided into groups based on the time they completed the second session: before or during the COVID-19 outbreak ‘Pre-pandemic Controls’ and ‘Pandemics’, respectively. The Pandemics were characterized by a higher extraversion and stronger connectivity, compared to Pre-pandemic Controls. Furthermore, the Pandemics improved their cognitive performance under long-term stress as compared to the Pre-Pandemic Controls matched for personality traits to the Pandemics. The Pandemics were also characterized by increased EEG connectivity during lockdown. We posit that stronger EEG connectivity and higher extraversion could act as a defense mechanism against stress-related deterioration of cognitive functions.

Identifying Predictive Factors in Compliance with the COVID-19 Containment Measures: A Mediation Analysis

INTRODUCTION

The outbreak of the COVID-19 pandemic has led governments to implement some containment measures to flatten the curve of the diffusion of the virus. The current study aims to investigate individual differences in compliance with these restrictive behaviors. In a sample of Italian individuals (N = 300), we examined whether sociodemographic factors, personality traits, fatalism, and fear could be considered as possible predictors.

METHODS

We performed a series of standard multiple regression analyses and proposed a mediation analysis to test the associations among variables.

RESULTS

Overall, our results suggested that men are less likely to engage in preventive behaviors, younger individuals are more reluctant to adhere to social distancing mandates, and fear has a functional role in predicting positive outcomes.

CONCLUSION

The results of our analyses are discussed and suggestions for future research are provided.

Big Five traits, approach-avoidance motivation, concerns and adherence with COVID-19 prevention guidelines during the peak of pandemic in Croatia

Without the vaccine, the only way to prevent the spread of coronavirus is following Covid-19 preventive guidelines such as keeping social distance, wearing masks and gloves, reducing mobility, etc. Success depends on how many individuals strictly follow the suggestions from epidemiologists. In this study, we examined who and why is adhering to the guidelines. A community sample of 500 participants fulfilled a short Big Five Inventory (BFI), Questionnaire of Approach and Avoidance Motivation (QAAM), and two scales constructed according to the Covid-19 epidemiological guidelines in Croatia. The results of the hierarchical regression analysis indicate that agreeable and conscientious individuals are complying more with preventive measures. In addition, approach, not avoidance, motivation appears to be more important in following the guidelines. Results are discussed in terms of framing messages to explain goals that might be reached by compliant behaviour rather than emphasising the negative consequences of the pandemic. Emphasising negative consequences seems to produce negative emotional states with no beneficial changes on the behavioural level.

DSM-5 pathological personality domains as vulnerability factors in predicting COVID-19-related anxiety symptoms

Since the beginning of the coronavirus disease-2019 (COVID-19) outbreak, individuals worldwide have shown different anxiety-related reactions. Several vulnerability factors may play a role in individuals' psychological reactions to the COVID-19 pandemic. Such factors include pathological personality traits which have been shown to contribute to the development of anxiety-related conditions. Consequently, the present study investigated the relationships between DSM-5 pathological personality domains and COVID-19-related anxiety symptoms. Using an online data portal, the relationships between DSM-5 pathological personality domains and COVID-19-related anxiety symptoms among a mixed university student and community sample (N = 612) were studied. The results showed that there was a positive and significant relationship between all DSM-5 pathological personality domains and COVID-19-related anxiety. The results of multiple linear regression analysis showed that DSM-5 pathological personality domains explained 21% of COVID-19-related anxiety variance. Based on standardized coefficients, the Personality Inventory for DSM-5 (PID-5) negative affect domain had the main role in COVID-19-related anxiety. The findings suggest that pathological personality domains can be predictors in the symptoms of anxiety in a viral outbreak. The novel findings add to the literature on individual differences in domains of personality in response to pandemic situations. Implications for future clinical applications and research investigations are discussed.

The Relationship of Fear of Death Between Neuroticism and Anxiety During the Covid-19 Pandemic

After a lockdown, particularly one where human life is at risk, there are expected to be psychological consequences. The examination of personality traits, where different adaptative and non-adaptative behaviors in the face of adversity are expected, is our interest. The aim of this research was to analyze the role fear of personal death played during the Covid-19 outbreak in relation to personality and anxiety. The main results can be described as follows: women displayed higher scores on anxiety and fear of personal death; gender, fear of personal death, neuroticism, and extraversion predicted anxiety; in men, the fear of personal death mediated the relationship between neuroticism and anxiety.

Personality Traits in Burning Mouth Syndrome Patients With and Without a History of Depression

Objectives: So far, the strong link between neuroticism, chronic pain, and depression has been well-documented in literatures. Some suggested that they might share etiological factors, thus resulting in overlapping constructs. However, such effect has never been tested in burning mouth syndrome (BMS) patients, a complex phenomenon influenced by both neuropathic and psychopathological factors. We aim to clarify how personality affects individual's pain and pain-related experiences. Methods: Two hundred forty-eight patients with BMS provided demographic information and psychiatric history; completed Ten-Item Personality Inventory, a Visual Analog Scale of pain, and McGill Pain Questionnaire; and provided adequate parameters of depressive state, catastrophizing thinking, and central sensitization. Results: BMS patients with depression history suffered more severe clinical symptoms and scored higher in neuroticism and less in openness and extraversion than did those without psychiatric diagnoses. After age, sex, and duration of pain were controlled, neuroticism in BMS patients with depression correlates with affective dimension of pain. Instead, if psychiatric history is absent, neuroticism correlates with sensory dimension and pain intensity. In both groups, higher neuroticism, unlike other personality facets, contributed to a more severe clinical condition. Conclusion: Of the five traits, neuroticism appears to be the most crucial dimension associated with the pain symptoms and patient's conditions. This study implies that management of pain must extend beyond solely providing pain-relieving medication and must require a holistic and multidisciplinary approach.

A systematic review of personality temperament models related to somatoform disorder with main focus on meta-analysis of Cloninger's theory components

The systematic review aims to identify four personality temperament models related to somatoform disorder with the main focus on the meta-analysis of temperaments and characters in Cloninger's theory. The literature search was performed on PubMed (Medline), Scopus, Web of Science, Cochrane, and ProQuest for all articles published in English from January 1990 to April 2019. Due to heterogeneity, pooled estimates of the standard mean difference between cases and controls were calculated using the random-effects model. Based on our inclusion criteria, 14 studies were identified, 7 of which were included in the meta-analysis. The results show that there is a significant difference between cases and controls with regard to harm avoidance (HA) (z = 5.322, P < 0.001), self-directedness (z = -4.719, P < 0.001), and self-transcendence (z = 2.848, P = 0.004). Compared to controls, HA and self-transcendence were higher and self-directedness was lower in cases. With regard to other subscales, there was no difference between the two groups (P > 0.05). The publication bias was not seen (P > 0.05 for Egger statistics). Up to now, very few studies have been focused on the relationship between personality temperament models and somatoform disorder. Among the components of the Cloninger's model, the poor self-directedness along with the abnormally high self-transcendence and HA is the personality component related to the somatoform disorder. Thus, Cloninger's model may potentially draw a personality profile for vulnerability to somatoform disorder. Given the limited number of studies available, future studies may challenge the results of the present study.

Personality Disorders Revisited: A Newly Proposed Mental Illness

Personality disorders such as dependent personality disorder (DPD), among others, have shown limited academic development in terms of a more in-depth understanding or subtypes that may exist as a mental illness or associated condition. DPD was first published as a distinct personality disorder in the Diagnostic and Statistical Manual for Mental Disorders, 3rd edition (DSM III) psychiatry manual in 1980. Since its revision in the DSM IIIR in 1987, no significant advancements have been proposed to date. This case study reported a patient with suicidal ideation and offered a new type of DPD to advance personality disorders research. The new subtype of dependent personality disorder has a few key characteristics of the traditional disorder yet reveals features that mirror nearly opposite symptom criteria, making it unique as a distinct subtype or possibly a separate personality disorder of its kind. The case study patient report proposes comorbid diagnoses of adjustment disorder and dependent personality disorder, the altruistic depressive type. Recommendations for further research were made.

Personality Traits, Risk Perception, and Protective Behaviors of Arab Residents of Qatar During the COVID-19 Pandemic

During the 2020 COVID-19 pandemic, people in Qatar—similar to most countries globally—were instructed by health authorities to adopt protective behaviors to avoid infection. One of these behaviors is social distancing, which is influenced by diverse variables. Using data from an online survey with 405 responses, this study performed multiple regression analysis to explore effects of personality, risk perception, and personal hygiene practices on social distancing among residents of Qatar. The results showed that 87.3% of participants reported that they preferred to stay at home and not go outside unless necessary, 60.3% said that they maintain an adequate distance when communicating with others, 68.6% reported that they do not allow relatives and friends to visit them at home, 73.5% believed that COVID-19 is a dangerous disease, and 95.8% reported that they embrace personal hygiene practices and washing hands. Furthermore, multiple regression analysis showed that conscientiousness, neuroticism, risk perception, and personal hygiene practices predicted social distancing, with moderate effect sizes. Gender differences were also found in social distancing practices, indicating that women reported higher engagement in social distancing practices than men. These results highlighted the importance of individual differences in reacting to the COVID-19 pandemic and provide important information about the predictors of social distancing practices.

Psychiatric characteristics of older persons with medically unexplained symptoms: A comparison with older patients suffering from medically explained symptoms

BACKGROUND

Empirical studies on the clinical characteristics of older persons with medically unexplained symptoms are limited to uncontrolled pilot studies. Therefore, we aim to examine the psychiatric characteristics of older patients with medically unexplained symptoms (MUS) compared to older patients with medically explained symptoms (MES), also across healthcare settings.

METHODS

A case-control study including 118 older patients with MUS and 154 older patients with MES. To include patients with various developmental and severity stages, patients with MUS were recruited in the community (n = 12), primary care (n = 77), and specialized healthcare (n = 29). Psychopathology was assessed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria (Mini-International Neuropsychiatric Interview) and by dimensional measures (e.g., psychological distress, hypochondriasis, and depressive symptoms).

RESULTS

A total of 69/118 (58.5%) patients with MUS met the criteria for a somatoform disorder according to DSM-IV-TR criteria, with the highest proportion among patients recruited in specialized healthcare settings (p = 0.008). Patients with MUS had a higher level of psychological distress and hypochondriasis compared to patients with MES. Although psychiatric disorders (beyond somatoform disorders) were more frequently found among patients with MUS compared to patients with MES (42.4 vs. 24.8%, p = 0.008), this difference disappeared when adjusted for age, sex, and level of education (odds ratio = 1.7 [95% confidence interval: 1.0-3.0], p = 0.070).

CONCLUSIONS

Although psychological distress is significantly higher among older patients with MUS compared to those with MES, psychiatric comorbidity rates hardly differ between both patient groups. Therefore, treatment of MUS in later life should primarily focus on reducing psychological distress, irrespective of the healthcare setting patients are treated in.

Less agreeable, better preserved? A PET amyloid and MRI study in a community-based cohort

The relationship between personality profiles and brain integrity in old age is still a matter of debate. We examined the association between Big Five factor and facet scores and MRI brain volume changes on a 54-month follow-up in 65 elderly controls with 3 neurocognitive assessments (baseline, 18 months, and 54 months), structural brain MRI (baseline and 54 months), brain amyloid PET during follow-up, and APOE genotyping. Personality was assessed with the Neuroticism Extraversion Openness Personality Inventory-Revised. Regression models were used to identify predictors of volume loss including time, age, sex, personality, amyloid load, presence of APOE ε4 allele, and cognitive evolution. Lower agreeableness factor scores (and 4 of its facets) were associated with lower volume loss in the hippocampus, entorhinal cortex, amygdala, mesial temporal lobe, and precuneus bilaterally. Higher openness factor scores (and 2 of its facets) were also associated with lower volume loss in the left hippocampus. Our findings persisted when adjusting for confounders in multivariable models. These data suggest that the combination of low agreeableness and high openness is an independent predictor of better preservation of brain volume in areas vulnerable to neurodegeneration.

Personality Factors' Impact on the Structural Integrity of Mentalizing Network in Old Age: A Combined PET-MRI Study

The mentalizing network (MN) treats social interactions based on our understanding of other people's intentions and includes the medial prefrontal cortex (mPFC), temporoparietal junction (TPJ), posterior cingulate cortex (PCC), precuneus (PC), and amygdala. Not all elders are equally affected by the aging-related decrease of mentalizing abilities. Personality has recently emerged as a strong determinant of functional connectivity in MN areas. However, its impact on volumetric changes across the MN in brain aging is still unknown. To address this issue, we explored the determinants of volume decrease in MN components including amyloid burden, personality, and APOE genotyping in a previously established cohort of 130 healthy elders with a mean follow-up of 54 months. Personality was assessed with the Neuroticism Extraversion Openness Personality Inventory-Revised. Regression models corrected for multiple comparisons were used to identify predictors of volume loss including time, age, sex, personality, amyloid load, presence of APOE epsilon 4 allele, and cognitive evolution. In cases with higher Agreeableness scores, there were lower volume losses in PCC, PC, and amygdala bilaterally. This was also the case for the right mPFC in elders displaying lower Agreeableness and Conscientiousness. In multiple regression models, the effect of Agreeableness was still observed in left PC and right amygdala and that of Conscientiousness was still observed in right mPFC volume loss (26.3% of variability, significant age and sex). Several Agreeableness (Modesty) and Conscientiousness (order, dutifulness, achievement striving, and self-discipline) facets were positively related to increased volume loss in cortical components of the MN. In conclusion, these data challenge the beneficial role of higher levels of Agreeableness and Conscientiousness in old age, showing that they are associated with an increased rate of volume loss within the MN.

Commentary on Special Issue on Geriatric Assessment

We provide commentary about the articles in this special section of "Assessment in Older Adults" by using van Alphen's framework of a systematic multidimensional approach for diagnosis and treatment in older adults.

Explanation of somatic symptoms by mental health and personality traits: application of Bayesian regularized quantile regression in a large population study

BACKGROUND

Somatic syndrome is one of the remarkably prevalent issues in primary health care and subspecialty settings. We aimed to elucidate multidimensional associations between somatic symptoms with major mental problems and personality traits in the framework of the quantile regression model with a Bayesian approach.

METHODS

A total of 4763 employees at Isfahan University of Medical Sciences and Health Services in Isfahan province, Iran, filled out four validated questionnaires including Hospital Anxiety and Depression Scale (HADS), NEO Questionnaire, General Health Questionnaire (GHQ) and PHQ-15 for somatic symptom severity. In addition, Functional Gastrointestinal Disorders (FGIDs) were determined using Rome IV criteria. Exploratory Factor Analysis (EFA) and Bayesian regularized quantile regression with adaptive LASSO penalization were applied for reduced dimension of somatic symptoms and variable selection and parameter estimation, respectively.

RESULTS

The 25 major somatic symptoms were grouped into four factors including general, upper gastrointestinal, lower gastrointestinal and respiratory by EFA. Stress, depression, and anxiety had significant effects on all of the four extracted factors. The effect of anxiety in each four extracted factors was more than stress and depression. Neuroticism and agreeableness had significant effects on all of the four extracted factors, generally (p < 0.05).

CONCLUSIONS

Given the high prevalence of somatic symptoms and psychosomatic complaints in correlation with the diverse range of mental co-morbidities, developing more detailed diagnostic tools and methods is crucial; nonetheless, it seems that providing better interdisciplinary approaches in general medical practice is groundwork.

Medically Unexplained Physical Symptoms in Hospitalized Patients: A 9-Year Retrospective Observational Study

Introduction: "Medically Unexplained Physical Symptoms" (MUPS) defines a subgroup of patients presenting physical symptoms of unclear origin. The study aims to profile clinical and socio-demographic characteristics of patients with MUPS. Materials and Methods: This 9-years observational retrospective study assesses all patients admitted between 2008 and 2016 in the divisions of neurology and gastroenterology. Socio-demographic and clinical variables were evaluated: gender, age, diagnosis or diagnostic hypothesis, presence of psychiatric comorbidities, psychiatric evaluation, pharmacological treatment, number of admissions/visits. Results: Among 2,479 neurological patients 10.1% presented MUPS. Patients were more frequently women (63.5%), with a mean age of about 50 years. Reported symptoms were headache (22.6%), seizures (8.7%), vertigo (5.9%), fibromyalgia (5.5%), paresthesia (5.1%), visual disturbances (5.1%), amnesia (3.9%). The diagnosis was somatoform disorder in 6.3% of cases, conversion disorder in 2.7%, and somatic symptom disorder in 1.5% only. 2,560 outpatients were evaluated in gastroenterology division. 9.6% (n = 248) of patients had MUPS; 62.1% of them were women. The most affected age group ranged between 15 and 45 years. The most frequent diagnoses were functional abdominal pain (50%), dysmotility-like dyspepsia (26.6%), irritable bowel syndrome (10.4%), meteorism of unknown cause (2.4%), hiccup (1.6%), burning mouth syndrome (1.2%). No patients received a diagnosis of somatic symptom disorder. Discussion: Patients with MUPS are more often women, of middle age, with self-referred specific symptomatology. While neurological patients received a diagnostic-therapeutic approach in line with the literature, gastroenterological patients mainly received antipsychotics. A more comprehensive assessment and a development of psychoeducational interventions are needed to improve patients' quality and quantity of life.