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Chung ML, Seib-Pfeifer LE, Elling C, Geiser F, Forstner AJ, Schumacher J, Conrad R. Personality subtypes in adults with social anxiety disorder - novelty seeking makes the difference. BMC Psychiatry 2022; 22:832. [PMID: 36575407 PMCID: PMC9793521 DOI: 10.1186/s12888-022-04484-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Up to now several subtypes of social anxiety disorder (SAD) have been proposed. METHODS In the present study, we used a cluster analytic approach to identify qualitatively different subgroups of SAD based on temperament characteristics, that is, harm avoidance (HA) and novelty seeking (NS) dimensions of Cloninger's Temperament and Character Inventory. RESULTS Based on a large, diverse clinical sample (n = 575), we found evidence for two distinct subgroups of SAD: a larger (59%) prototypic, inhibited cluster characterized by high HA and low NS, and a smaller atypic, and comparatively more impulsive cluster characterized by medium to high HA and increased NS. The subgroups differed regarding a variety of sociodemographic and clinical variables. While the prototypic SAD subtype suffered from more severe SAD and depressive symptoms, suicidal ideation, and reduced social functioning, the atypic NS subtype showcased higher reproductive behaviour, self-directedness and -transcendence, comparatively. Additional hierarchical logistic regression highlights the contribution of age and education. CONCLUSIONS Our results valuably extend previous evidence for the existence of at least two distinct subtypes of SAD. A better knowledge of the characteristic differences in prototypic behaviour, personality, coping strategies and comorbidities between the identified (and further) subtypes can contribute to the development of effective prevention interventions and promotes the conceptualization of tailored treatments.
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Affiliation(s)
- Man-Long Chung
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
| | - Laura-Effi Seib-Pfeifer
- grid.10388.320000 0001 2240 3300Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111 Bonn, Germany
| | - Christina Elling
- grid.15090.3d0000 0000 8786 803XDepartment of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Franziska Geiser
- grid.15090.3d0000 0000 8786 803XDepartment of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Andreas J. Forstner
- grid.10388.320000 0001 2240 3300Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany ,grid.8385.60000 0001 2297 375XInstitute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Wilhelm-Johnen-Straße, 52428 Jülich, Germany ,grid.10253.350000 0004 1936 9756Centre for Human Genetics, University of Marburg, Baldingerstraße, 35033 Marburg, Germany
| | - Johannes Schumacher
- grid.10253.350000 0004 1936 9756Centre for Human Genetics, University of Marburg, Baldingerstraße, 35033 Marburg, Germany
| | - Rupert Conrad
- grid.15090.3d0000 0000 8786 803XDepartment of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany ,grid.16149.3b0000 0004 0551 4246Department of Psychosomatic Medicine and Psychotherapy, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
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Changes in temperament traits associated with remission of PTSD symptoms after pharmacology, psychotherapy and combined treatment in a sample of participants in motor vehicle accidents. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2021.111493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Predictors of social anxiety disorder with major depressive episodes among Japanese university students. PLoS One 2021; 16:e0257793. [PMID: 34570818 PMCID: PMC8476026 DOI: 10.1371/journal.pone.0257793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/10/2021] [Indexed: 11/19/2022] Open
Abstract
Background Social anxiety disorder (SAD) develops in the early teens and is a common disorder among university students. Understanding the predictive factors of SAD comorbid with major depressive episode (MDE) is important for student mental health care. The aim of this study was to identify the personality traits that predict SAD with MDE by analyzing longitudinal data of Japanese university students. Methods In this retrospective study, Japanese university students who visited the health care center of Hokkaido University for the first time were divided into the following four groups: “Control” (n = 43), “MDE” (n = 16), “SAD” (n = 28), and “SAD with MDE” (n = 61) based on the Patient Health Questionnaire-9 (PHQ-9), the Liebowitz Social Anxiety Scale, and core anxiety symptoms for SAD in the Mini International Neuropsychiatric Interview during screening. Predictors for SAD with MDE were identified by a four-group comparison of the Temperament and Character Inventory and PHQ-9 data previously obtained at the enrollment using analysis of variance and post-hoc tests. Results Upon comparing the four groups using analysis of variance, there were significant differences in the baseline PHQ-9 summary score, Harm-Avoidance (HA), and Self-Directedness (SD). According to results of the post-hoc test, all three showed a significant difference between the “Control” and “SAD with MDE.” Furthermore, there was a significant difference in HA scores between “SAD” and “Control.” In all the groups, the mean time from enrollment to the first visit to the center was >2 years. Conclusion A higher HA score at baseline is a predictor of SAD with or without MDE. Higher PHQ-9 summary and lower SD scores at baseline are predictive factors of SAD with MDE.
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Gibbon S, Khalifa NR, Cheung NHY, Völlm BA, McCarthy L. Psychological interventions for antisocial personality disorder. Cochrane Database Syst Rev 2020; 9:CD007668. [PMID: 32880104 PMCID: PMC8094166 DOI: 10.1002/14651858.cd007668.pub3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Antisocial personality disorder (AsPD) is associated with poor mental health, criminality, substance use and relationship difficulties. This review updates Gibbon 2010 (previous version of the review). OBJECTIVES To evaluate the potential benefits and adverse effects of psychological interventions for adults with AsPD. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 13 other databases and two trials registers up to 5 September 2019. We also searched reference lists and contacted study authors to identify studies. SELECTION CRITERIA Randomised controlled trials of adults, where participants with an AsPD or dissocial personality disorder diagnosis comprised at least 75% of the sample randomly allocated to receive a psychological intervention, treatment-as-usual (TAU), waiting list or no treatment. The primary outcomes were aggression, reconviction, global state/functioning, social functioning and adverse events. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS This review includes 19 studies (eight new to this update), comparing a psychological intervention against TAU (also called 'standard Maintenance'(SM) in some studies). Eight of the 18 psychological interventions reported data on our primary outcomes. Four studies focussed exclusively on participants with AsPD, and 15 on subgroups of participants with AsPD. Data were available from only 10 studies involving 605 participants. Eight studies were conducted in the UK and North America, and one each in Iran, Denmark and the Netherlands. Study duration ranged from 4 to 156 weeks (median = 26 weeks). Most participants (75%) were male; the mean age was 35.5 years. Eleven studies (58%) were funded by research councils. Risk of bias was high for 13% of criteria, unclear for 54% and low for 33%. Cognitive behaviour therapy (CBT) + TAU versus TAU One study (52 participants) found no evidence of a difference between CBT + TAU and TAU for physical aggression (odds ratio (OR) 0.92, 95% CI 0.28 to 3.07; low-certainty evidence) for outpatients at 12 months post-intervention. One study (39 participants) found no evidence of a difference between CBT + TAU and TAU for social functioning (mean difference (MD) -1.60 points, 95% CI -5.21 to 2.01; very low-certainty evidence), measured by the Social Functioning Questionnaire (SFQ; range = 0-24), for outpatients at 12 months post-intervention. Impulsive lifestyle counselling (ILC) + TAU versus TAU One study (118 participants) found no evidence of a difference between ILC + TAU and TAU for trait aggression (assessed with Buss-Perry Aggression Questionnaire-Short Form) for outpatients at nine months (MD 0.07, CI -0.35 to 0.49; very low-certainty evidence). One study (142 participants) found no evidence of a difference between ILC + TAU and TAU alone for the adverse event of death (OR 0.40, 95% CI 0.04 to 4.54; very low-certainty evidence) or incarceration (OR 0.70, 95% CI 0.27 to 1.86; very low-certainty evidence) for outpatients between three and nine months follow-up. Contingency management (CM) + SM versus SM One study (83 participants) found evidence that, compared to SM alone, CM + SM may improve social functioning measured by family/social scores on the Addiction Severity Index (ASI; range = 0 (no problems) to 1 (severe problems); MD -0.08, 95% CI -0.14 to -0.02; low-certainty evidence) for outpatients at six months. 'Driving whilst intoxicated' programme (DWI) + incarceration versus incarceration One study (52 participants) found no evidence of a difference between DWI + incarceration and incarceration alone on reconviction rates (hazard ratio 0.56, CI -0.19 to 1.31; very low-certainty evidence) for prisoner participants at 24 months. Schema therapy (ST) versus TAU One study (30 participants in a secure psychiatric hospital, 87% had AsPD diagnosis) found no evidence of a difference between ST and TAU for the number of participants who were reconvicted (OR 2.81, 95% CI 0.11 to 74.56, P = 0.54) at three years. The same study found that ST may be more likely to improve social functioning (assessed by the mean number of days until patients gain unsupervised leave (MD -137.33, 95% CI -271.31 to -3.35) compared to TAU, and no evidence of a difference between the groups for overall adverse events, classified as the number of people experiencing a global negative outcome over a three-year period (OR 0.42, 95% CI 0.08 to 2.19). The certainty of the evidence for all outcomes was very low. Social problem-solving (SPS) + psychoeducation (PE) versus TAU One study (17 participants) found no evidence of a difference between SPS + PE and TAU for participants' level of social functioning (MD -1.60 points, 95% CI -5.43 to 2.23; very low-certainty evidence) assessed with the SFQ at six months post-intervention. Dialectical behaviour therapy versus TAU One study (skewed data, 14 participants) provided very low-certainty, narrative evidence that DBT may reduce the number of self-harm days for outpatients at two months post-intervention compared to TAU. Psychosocial risk management (PSRM; 'Resettle') versus TAU One study (skewed data, 35 participants) found no evidence of a difference between PSRM and TAU for a number of officially recorded offences at one year after release from prison. It also found no evidence of difference between the PSRM and TAU for the adverse event of death during the study period (OR 0.89, 95% CI 0.05 to 14.83, P = 0.94, 72 participants (90% had AsPD), 1 study, very low-certainty evidence). AUTHORS' CONCLUSIONS There is very limited evidence available on psychological interventions for adults with AsPD. Few interventions addressed the primary outcomes of this review and, of the eight that did, only three (CM + SM, ST and DBT) showed evidence that the intervention may be more effective than the control condition. No intervention reported compelling evidence of change in antisocial behaviour. Overall, the certainty of the evidence was low or very low, meaning that we have little confidence in the effect estimates reported. The conclusions of this update have not changed from those of the original review, despite the addition of eight new studies. This highlights the ongoing need for further methodologically rigorous studies to yield further data to guide the development and application of psychological interventions for AsPD and may suggest that a new approach is required.
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Affiliation(s)
- Simon Gibbon
- Arnold Lodge, Nottinghamshire Healthcare NHS Foundation Trust, Leicester, UK
| | - Najat R Khalifa
- Department of Psychiatry, Queen's University, Kingston, Canada
| | - Natalie H-Y Cheung
- Forensic Research, Nottinghamshire Healthcare NHS Foundation Trust, Leicester, UK
| | - Birgit A Völlm
- Department of Forensic Psychiatry, Center for Neurology, University Rostock, Rostock, Germany
| | - Lucy McCarthy
- Arnold Lodge, Nottinghamshire Healthcare NHS Foundation Trust, Leicester, UK
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Costache ME, Frick A, Månsson K, Engman J, Faria V, Hjorth O, Hoppe JM, Gingnell M, Frans Ö, Björkstrand J, Rosén J, Alaie I, Åhs F, Linnman C, Wahlstedt K, Tillfors M, Marteinsdottir I, Fredrikson M, Furmark T. Higher- and lower-order personality traits and cluster subtypes in social anxiety disorder. PLoS One 2020; 15:e0232187. [PMID: 32348331 PMCID: PMC7190155 DOI: 10.1371/journal.pone.0232187] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 04/08/2020] [Indexed: 02/03/2023] Open
Abstract
Social anxiety disorder (SAD) can come in different forms, presenting problems for diagnostic classification. Here, we examined personality traits in a large sample of patients (N = 265) diagnosed with SAD in comparison to healthy controls (N = 164) by use of the Revised NEO Personality Inventory (NEO-PI-R) and Karolinska Scales of Personality (KSP). In addition, we identified subtypes of SAD based on cluster analysis of the NEO-PI-R Big Five personality dimensions. Significant group differences in personality traits between patients and controls were noted on all Big Five dimensions except agreeableness. Group differences were further noted on most lower-order facets of NEO-PI-R, and nearly all KSP variables. A logistic regression analysis showed, however, that only neuroticism and extraversion remained significant independent predictors of patient/control group when controlling for the effects of the other Big Five dimensions. Also, only neuroticism and extraversion yielded large effect sizes when SAD patients were compared to Swedish normative data for the NEO-PI-R. A two-step cluster analysis resulted in three separate clusters labelled Prototypical (33%), Introvert-Conscientious (29%), and Instable-Open (38%) SAD. Individuals in the Prototypical cluster deviated most on the Big Five dimensions and they were at the most severe end in profile analyses of social anxiety, self-rated fear during public speaking, trait anxiety, and anxiety-related KSP variables. While additional studies are needed to determine if personality subtypes in SAD differ in etiological and treatment-related factors, the present results demonstrate considerable personality heterogeneity in socially anxious individuals, further underscoring that SAD is a multidimensional disorder.
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Affiliation(s)
| | - Andreas Frick
- The Beijer Laboratory, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Kristoffer Månsson
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany and London, United Kingdom
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
| | - Jonas Engman
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Vanda Faria
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Center for Pain and The Brain, Department of Anesthesiology, Harvard Medical School, Boston Children’s Hospital, Perioperative and Pain Medicine, Boston, MA, United States of America
- Department of Otorhinolaryngology, Smell & Taste Clinic, TU Dresden, Dresden, Germany
| | - Olof Hjorth
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | | | - Malin Gingnell
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Örjan Frans
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Johannes Björkstrand
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Psychology, Lund University, Lund, Sweden
| | - Jörgen Rosén
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Iman Alaie
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Fredrik Åhs
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Clas Linnman
- Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, United States of America
| | - Kurt Wahlstedt
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Maria Tillfors
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Ina Marteinsdottir
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Mats Fredrikson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
- * E-mail:
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Reinforcement sensitivity, depression and anxiety: A meta-analysis and meta-analytic structural equation model. Clin Psychol Rev 2020; 77:101842. [PMID: 32179341 DOI: 10.1016/j.cpr.2020.101842] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 02/06/2020] [Accepted: 03/04/2020] [Indexed: 12/21/2022]
Abstract
Reinforcement Sensitivity Theory (RST) posits that individual differences in reward and punishment processing predict differences in cognition, behavior, and psychopathology. We performed a quantitative review of the relationships between reinforcement sensitivity, depression and anxiety, in two separate sets of analyses. First, we reviewed 204 studies that reported either correlations between reinforcement sensitivity and self-reported symptom severity or differences in reinforcement sensitivity between diagnosed and healthy participants, yielding 483 effect sizes. Both depression (Hedges' g = .99) and anxiety (g = 1.21) were found to be high on punishment sensitivity. Reward sensitivity negatively predicted only depressive disorders (g = -.21). More severe clinical states (e.g., acute vs remission) predicted larger effect sizes for depression but not anxiety. Next, we reviewed an additional 39 studies that reported correlations between reinforcement sensitivity and both depression and anxiety, yielding 156 effect sizes. We then performed meta-analytic structural equation modeling to simultaneously estimate all covariances and control for comorbidity. Again we found punishment sensitivity to predict depression (β = .37) and anxiety (β = .35), with reward sensitivity only predicting depression (β = -.07). The transdiagnostic role of punishment sensitivity and the discriminatory role of reward sensitivity support a hierarchical approach to RST and psychopathology.
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Further evidence for genetic variation at the serotonin transporter gene SLC6A4 contributing toward anxiety. Psychiatr Genet 2017; 27:96-102. [DOI: 10.1097/ypg.0000000000000171] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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The influence of personality traits and emotional and behavioral problems on repetitive nonsuicidal self-injury in a school sample. Compr Psychiatry 2017; 74:214-223. [PMID: 28231481 DOI: 10.1016/j.comppsych.2017.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 02/02/2017] [Accepted: 02/11/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is highly prevalent among adolescents and associated with various mental health problems and suicidality. Previous studies have found that certain personality traits are related to NSSI behavior, however only few studies examined personality traits in adolescents with NSSI. Our study aimed to assess the relationship between personality traits and emotional and behavioral problems in predicting repetitive NSSI among adolescents from a school sample. METHODS Four hundred and forty-seven students (M=14.95years, SD=0.74, 52% male) completed self-report measures on NSSI, personality traits, and emotional and behavioral problems. RESULTS The past year prevalence of occasional and repetitive NSSI was 4.9% and 6.3% respectively. Repetitive NSSI was significantly associated with female gender, higher levels of age, novelty seeking, harm avoidance, self-transcendence, antisocial behavior, and positive self and lower levels of persistence and self-directedness in univariate analyses. However, multivariate logistic regression analyses indicated that only high levels of antisocial behavior and low levels of self-directedness significantly predicted repetitive NSSI. CONCLUSIONS The association between a lack of self-directedness and NSSI emphasizes the significance of targeting self-directedness in psychotherapy by strengthening self-awareness, affect tolerance and emotion regulation, as well as establishing and pursuing long-term goals.
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Wiltink J, Hoyer J, Beutel ME, Ruckes C, Herpertz S, Joraschky P, Koranyi S, Michal M, Nolting B, Pöhlmann K, Salzer S, Strauss B, Leibing E, Leichsenring F. Do Patient Characteristics Predict Outcome of Psychodynamic Psychotherapy for Social Anxiety Disorder? PLoS One 2016; 11:e0147165. [PMID: 26785255 PMCID: PMC4718454 DOI: 10.1371/journal.pone.0147165] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 12/30/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Little is known about patient characteristics as predictors for outcome in manualized short term psychodynamic psychotherapy (PDT). No study has addressed which patient variables predict outcome of PDT for social anxiety disorder. RESEARCH DESIGN AND METHODS In the largest multicenter trial on psychotherapy of social anxiety (SA) to date comparing cognitive therapy, PDT and wait list condition N = 230 patients were assigned to receive PDT, of which N = 166 completed treatment. Treatment outcome was assessed based on diverse parameters such as endstate functioning, remission, response, and drop-out. The relationship between patient characteristics (demographic variables, mental co-morbidity, personality, interpersonal problems) and outcome was analysed using logistic and linear regressions. RESULTS Pre-treatment SA predicted up to 39 percent of variance of outcome. Only few additional baseline characteristics predicted better treatment outcome (namely, lower comorbidity and interpersonal problems) with a limited proportion of incremental variance (5.5 to 10 percent), while, e.g., shame, self-esteem or harm avoidance did not. CONCLUSIONS We argue that the central importance of pre-treatment symptom severity for predicting outcomes should advocate alternative treatment strategies (e.g. longer treatments, combination of psychotherapy and medication) in those who are most disturbed. Given the relatively small amount of variance explained by the other patient characteristics, process variables and patient-therapist interaction should additionally be taken into account in future research. TRIAL REGISTRATION Controlled-trials.com/ISRCTN53517394.
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Affiliation(s)
- Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jürgen Hoyer
- Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Christian Ruckes
- Interdisciplinary Centre for Clinical Trials (IZKS), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stephan Herpertz
- Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, Ruhr-University Bochum, Bochum, Germany
| | - Peter Joraschky
- Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany
| | - Susan Koranyi
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena, Jena, Germany
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Björn Nolting
- Clinic of Psychosomatics and Psychotherapeutic Medicine, Esslingen, Germany
| | - Karin Pöhlmann
- Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany
| | - Simone Salzer
- Clinic of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany
| | - Bernhard Strauss
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital Jena, Jena, Germany
| | - Eric Leibing
- Clinic of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany
| | - Falk Leichsenring
- Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany
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Smith CJW, Wilkins KB, Mogavero JN, Veenema AH. Social Novelty Investigation in the Juvenile Rat: Modulation by the μ-Opioid System. J Neuroendocrinol 2015. [PMID: 26212131 DOI: 10.1111/jne.12301] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The drive to approach and explore novel conspecifics is inherent to social animals and may promote optimal social functioning. Juvenile animals seek out interactions with novel peers more frequently and find these interactions to be more rewarding than their adult counterparts. In the present study, we aimed to establish a behavioural paradigm to measure social novelty-seeking in juvenile rats and to determine the involvement of the opioid, dopamine, oxytocin and vasopressin systems in this behaviour. To this end, we developed the social novelty preference test to assess the preference of a juvenile rat to investigate a novel over a familiar (cage mate) conspecific. We show that across the juvenile period both male and female rats spend more time investigating a novel conspecific than a cage mate, independent of subject sex or repeated exposure to the test. We hypothesised that brain systems subserving social information processing and social motivation/reward (i.e. the opioid, dopamine, oxytocin, vasopressin systems) might support social novelty preference. To test this, receptor antagonists of each of these systems were administered i.c.v. prior to exposure to the social novelty preference test and, subsequently, to the social preference test, to examine the specificity of these effects. We find that μ-opioid receptor antagonism reduces novel social investigation in both the social novelty preference and social preference tests while leaving the investigation of a cage mate (social novelty preference test) or an object (social preference test) unaffected. In contrast, central blockade of dopamine D2 receptors (with eticlopride), oxytocin receptors (with des-Gly-NH2,d(CH2)5[Tyr(Me)2,Thr4]OVT) or vasopressin V1a receptors [with (CH2)5Tyr(Me2)AVP] failed to alter social novelty preference or social preference. Overall, we have established a new behavioural test to study social novelty-seeking behaviour in the juvenile rat and show that the μ-opioid system facilitates this behaviour, possibly by reducing risk avoidance and enhancing the hedonic and/or motivational value of social novelty.
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Affiliation(s)
- C J W Smith
- Neurobiology of Social Behavior Laboratory, Department of Psychology, Boston College, Chestnut Hill, MA, USA
| | - K B Wilkins
- Neurobiology of Social Behavior Laboratory, Department of Psychology, Boston College, Chestnut Hill, MA, USA
| | - J N Mogavero
- Neurobiology of Social Behavior Laboratory, Department of Psychology, Boston College, Chestnut Hill, MA, USA
| | - A H Veenema
- Neurobiology of Social Behavior Laboratory, Department of Psychology, Boston College, Chestnut Hill, MA, USA
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Terock J, Janowitz D, Spitzer C, Miertsch M, Freyberger HJ, Grabe HJ. Alexithymia and self-directedness as predictors of psychopathology and psychotherapeutic treatment outcome. Compr Psychiatry 2015; 62:34-41. [PMID: 26343465 DOI: 10.1016/j.comppsych.2015.06.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 05/28/2015] [Accepted: 06/06/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Alexithymia, a common personality style of patients seeking psychotherapeutic help, is associated with illness severity and negative treatment outcome in various mental disorders. Still, it remains unclear how alexithymia influences psychopathology and the therapeutic processes. In previous studies, a strong association of alexithymia with self-directedness (SD), a dimension of Cloninger's Temperament and Character Inventory (TCI) has been shown. In this study, we investigated the interaction of alexithymia and SD, and their impact on general psychopathology and on treatment outcome. METHOD 716 consecutively admitted day-clinic outpatients were examined at admission (t0) and discharge (t1). The Toronto Alexithymia Scale 20 (TAS-20), the SD subscale of the TCI and the Symptom Checklist 90 (SCL-90-R) were administered. Linear regression analyses were performed to calculate associations and the predictive power of TAS-20 and SD on psychopathology at admission and treatment outcome. ANOVA was used to calculate interactions of TAS-20 and SD on treatment outcome. A general linear model was applied to compare the outcome of four subgroups, defined by high/low TAS-20 and SD scores. RESULTS Regression analyses revealed significant prediction of the baseline General Severity Index (GSIt0) by TAS-20 (df=4, 711; Beta: 0.385; p<0.001) and SD (Beta: -0.365; p<0.001). The whole model accounted for 41% of the explained variance. On subscale level, the 'Difficulties in identifying feelings' facet (DIF) of TAS-20 was the strongest predictor of GSIt0 (Beta: 0.478, P<0.001) and GSIt1 (Beta: 0.072, p=0.049). Therapeutic outcome measured by GSIt1 was significantly predicted by SD (df=5, 710; Beta: -0.065; p=0.041), but not by TAS-20 (Beta: 0.042; p=0.179). Change scores (∆) of TAS-20 and SD predicted GSIt1 (df=5, 710; TAS-20∆ Beta: -0.268; p<0.001; SD∆ Beta: 0.191; p<0.001) as well as GSI∆ (df=5, 710; TAS∆ Beta: 0.384; p<0.001; SD∆: -0.274; p<0.001) significantly. ANOVA revealed no significant interactions of TAS-20 and SD at admission on the treatment outcome (p>0.05). CONCLUSION Low SD was shown to be a common problem of alexithymic patients and both, alexithymia and SD were highly associated with general symptom severity. SD was found to have a greater impact on treatment outcome while adjusting for baseline GSI. Alexithymia and SD act as independent factors with no significant interaction in their impact on psychopathology at admission and discharge. As different interventions were shown to improve SD scores in previous studies, SD may represent a relevant psychotherapeutic target, worthy to be addressed especially in alexithymic patients. Future studies should investigate other dimensions of the TCI, especially harm avoidance and reward dependence.
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Affiliation(s)
- Jan Terock
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, HELIOS Klinikum Stralsund, Germany.
| | - Deborah Janowitz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, HELIOS Klinikum Stralsund, Germany
| | | | - Martin Miertsch
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, HELIOS Klinikum Stralsund, Germany
| | - Harald J Freyberger
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, HELIOS Klinikum Stralsund, Germany
| | - Hans Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, HELIOS Klinikum Stralsund, Germany
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Asano T, Baba H, Kawano R, Takei H, Maeshima H, Takahashi Y, Suzuki T, Arai H. Temperament and character as predictors of recurrence in remitted patients with major depression: a 4-year prospective follow-up study. Psychiatry Res 2015; 225:322-5. [PMID: 25560481 DOI: 10.1016/j.psychres.2014.12.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 12/02/2014] [Accepted: 12/12/2014] [Indexed: 11/28/2022]
Abstract
The aim of the present study was to examine whether the specific personality traits, Harm-Avoidance (HA) and Self-Directedness (SD) as measured by the Temperament and Character Inventory (TCI), were predictive for subsequent depressive episodes in remitted patients with major depressive disorders (MDDs) over a 4-year follow-up. A total of 109 inpatients with MDD participated in this study. The subjects completed the TCI when they were assessed to be in remission. They were divided into high or low HA groups and high or low SD groups, as discriminated by the quartile value. A total of 69 patients were followed-up over a 4-year period or until recurrence. Both Kaplan-Meier analysis and Cox׳s proportional hazards regression analysis indicated that patients with a low SD score had a significantly shorter time to recurrence from remission than patients with a high SD score even when some prognostic predictors were controlled for. In contrast, HA was not found to be a predictor of recurrence for future depressive episodes. A part of MDD patients with low scores in Self-Directedness are likely to develop depression over a subsequent period of time. Interventions that improve SD may help to delay recurrence of depression in MDD patients.
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Affiliation(s)
- Tadashi Asano
- Department of Human Science, Graduate School of Human Science, Bunkyo University, Saitama, Japan
| | - Hajime Baba
- Juntendo University Mood Disorder Project (JUMP), Department of Psychiatry, Juntendo University Koshigaya Hospital, Saitama, Japan; Department of Psychiatry, Juntendo University, School of Medicine, Tokyo, Japan.
| | - Rumiko Kawano
- Juntendo University Mood Disorder Project (JUMP), Department of Psychiatry, Juntendo University Koshigaya Hospital, Saitama, Japan; Department of Psychiatry, Juntendo University, School of Medicine, Tokyo, Japan
| | - Hiroto Takei
- Juntendo University Mood Disorder Project (JUMP), Department of Psychiatry, Juntendo University Koshigaya Hospital, Saitama, Japan
| | - Hitoshi Maeshima
- Juntendo University Mood Disorder Project (JUMP), Department of Psychiatry, Juntendo University Koshigaya Hospital, Saitama, Japan; Department of Psychiatry, Juntendo University, School of Medicine, Tokyo, Japan
| | - Yukina Takahashi
- Juntendo University Mood Disorder Project (JUMP), Department of Psychiatry, Juntendo University Koshigaya Hospital, Saitama, Japan
| | - Toshihito Suzuki
- Juntendo University Mood Disorder Project (JUMP), Department of Psychiatry, Juntendo University Koshigaya Hospital, Saitama, Japan; Department of Psychiatry, Juntendo University, School of Medicine, Tokyo, Japan
| | - Heii Arai
- Department of Psychiatry, Juntendo University, School of Medicine, Tokyo, Japan
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Binelli C, Muñiz A, Sanches S, Ortiz A, Navines R, Egmond E, Udina M, Batalla A, López-Sola C, Crippa JA, Subirà S, Martín-Santos R. New evidence of heterogeneity in social anxiety disorder: defining two qualitatively different personality profiles taking into account clinical, environmental and genetic factors. Eur Psychiatry 2014; 30:160-5. [PMID: 25499444 DOI: 10.1016/j.eurpsy.2014.09.418] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 08/22/2014] [Accepted: 09/21/2014] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To study qualitatively different subgroups of social anxiety disorder (SAD) based on harm avoidance (HA) and novelty seeking (NS) dimensions. METHOD One hundred and forty-two university students with SAD (SCID-DSM-IV) were included in the study. The temperament dimensions HA and NS from the Cloninger's Temperament and Character Inventory were subjected to cluster analysis to identify meaningful subgroups. The identified subgroups were compared for sociodemographics, SAD severity, substance use, history of suicide and self-harm attempts, early life events, and two serotonin transporter gene polymorphisms (5-HTTLPR and STin2.VNTR). RESULTS Two subgroups of SAD were identified by cluster analysis: a larger (61% of the sample) inhibited subgroup of subjects with "high-HA/low-NS", and a smaller (39%) atypical impulsive subgroup with high-moderate HA and NS. The two groups did not differ in social anxiety severity, but did differ in history of lifetime impulsive-related-problems. History of suicide attempts and self-harm were as twice as frequent in the impulsive subgroup. Significant differences were observed in the pattern of substance misuse. Whereas subjects in the inhibited subgroup showed a greater use of alcohol (P=0.002), subjects in the impulsive subgroup showed a greater use of substances with a high-sensation-seeking profile (P<0.001). The STin2.VNTR genotype frequency showed an inverse distribution between subgroups (P=0.005). CONCLUSIONS Our study provides further evidence for the presence of qualitatively different SAD subgroups and the propensity of a subset of people with SAD to exhibit impulsive, high-risk behaviors.
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Affiliation(s)
- C Binelli
- Service of Psychiatry and Psychology, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Clinical and Health Psychology, Autonomous University of Barcelona, Bellaterra, Spain
| | - A Muñiz
- Service of Psychiatry and Psychology, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - S Sanches
- Service of Psychiatry and Psychology, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Neuroscience and Cognitive Behavior, Hospital das Clinicas, Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - A Ortiz
- Service of Psychiatry and Psychology, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - R Navines
- Service of Psychiatry and Psychology, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain; Human Pharmacology and Clinical Neurosciences Research Group, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - E Egmond
- Service of Psychiatry and Psychology, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Clinical and Health Psychology, Autonomous University of Barcelona, Bellaterra, Spain
| | - M Udina
- Service of Psychiatry and Psychology, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - A Batalla
- Service of Psychiatry and Psychology, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - C López-Sola
- Department of Clinical and Health Psychology, Autonomous University of Barcelona, Bellaterra, Spain
| | - J A Crippa
- Department of Neuroscience and Cognitive Behavior, Hospital das Clinicas, Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil
| | - S Subirà
- Department of Clinical and Health Psychology, Autonomous University of Barcelona, Bellaterra, Spain
| | - R Martín-Santos
- Service of Psychiatry and Psychology, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain.
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Hedman E, Andersson G, Lindefors N, Gustavsson P, Lekander M, Rück C, Andersson E, Ljótsson B. Personality change following internet-based cognitive behavior therapy for severe health anxiety. PLoS One 2014; 9:e113871. [PMID: 25437150 PMCID: PMC4250052 DOI: 10.1371/journal.pone.0113871] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 11/02/2014] [Indexed: 11/23/2022] Open
Abstract
Personality traits have traditionally been viewed as stable, but recent studies suggest that they could be affected through psychological treatment. Internet-based cognitive behavior therapy (ICBT) for severe health anxiety (DSM-IV hypochondriasis) has been shown to be effective in reducing health anxiety, but its effect on measures of personality traits has not been investigated. The main aim of this study was to investigate the impact of ICBT on personality traits in the three broad dimensions - neuroticism, extraversion and aggression. We hypothesized that participants in ICBT would reduce their level of neuroticism compared to controls that did not receive the active treatment. No specific predictions were made regarding extraversion and aggression. Data from a randomized controlled trial were used in which participants were allocated to 12 weeks of ICBT (n = 40) or to a basic attention control condition (n = 41). Personality traits were assessed with the Swedish Universities Scales of Personality and the primary outcome of health anxiety was the Health Anxiety Inventory. There was a significant interaction effect of group and time on neuroticism-related scales, indicating larger pre- to post-treatment reductions in the Internet-based CBT group compared to the control condition. Analyses at 6-month follow-up showed that changes were stable. Traits relating to extraversion and aggression were largely unchanged. This study is the first to demonstrate that a brief ICBT intervention for severe health anxiety causes long-term changes in measures of personality traits related to neuroticism. The treatment thus has a broader impact than just reducing health anxiety. Trial Registration Clinicaltrials.gov (ID NCT00828152)
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Affiliation(s)
- Erik Hedman
- Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Gerhard Andersson
- Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Swedish Institute for Disability Research, Linköping University, Linköping, Sweden
| | - Nils Lindefors
- Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - Petter Gustavsson
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Mats Lekander
- Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet, Stockholm, Sweden
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Christian Rück
- Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - Erik Andersson
- Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - Brjánn Ljótsson
- Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
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Mörtberg E, Tillfors M, van Zalk N, Kerr M. An atypical anxious-impulsive pattern of social anxiety disorder in an adult clinical population. Scand J Psychol 2014; 55:350-6. [PMID: 24716675 DOI: 10.1111/sjop.12117] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 01/07/2014] [Indexed: 11/29/2022]
Abstract
An atypical subgroup of Social Anxiety Disorder (SAD) with impulsive rather than inhibited traits has recently been reported. The current study examined whether such an atypical subgroup could be identified in a clinical population of 84 adults with SAD. The temperament dimensions harm avoidance and novelty seeking of the Temperament and Character Inventory, and the Liebowitz Social Anxiety Scale were used in cluster analyses. The identified clusters were compared on depressive symptoms, the character dimension self-directedness, and treatment outcome. Among the six identified clusters, 24% of the sample had atypical characteristics, demonstrating mainly generalized SAD in combination with coexisting traits of inhibition and impulsivity. As additional signs of severity, this group showed low self-directedness and high levels of depressive symptoms. We also identified a typically inhibited subgroup comprising generalized SAD with high levels of harm avoidance and low levels of novelty seeking, with a similar clinical severity as the atypical subgroup. Thus, higher levels of harm avoidance and social anxiety in combination with higher or lower levels of novelty seeking and low self-directedness seem to contribute to a more severe clinical picture. Post hoc examination of the treatment outcome in these subgroups showed that only 20 to 30% achieved clinically significant change.
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Affiliation(s)
- Ewa Mörtberg
- Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Clinical Neuroscience/Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
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Mörtberg E, Andersson G. Predictors of response to individual and group cognitive behaviour therapy of social phobia. Psychol Psychother 2014; 87:32-43. [PMID: 23335452 DOI: 10.1111/papt.12002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 12/06/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Increased knowledge of factors that predict treatment outcome is important for planning and individualizing of treatment. This study analysed predictors of response to individual cognitive therapy (ICT), and intensive (3-week) group cognitive treatment (IGCT) for social phobia. METHOD Participants (n = 54) met diagnostic criteria for social phobia within a randomized controlled trial. Predictors assessed were fear of negative evaluation, anticipatory worry, self-directedness (SD) and cluster C personality disorder. Results were analysed by means of multiple regression analyses with both groups combined, and for each of the treatment groups. RESULTS Anticipatory worry, an aspect of a harm-avoidance personality trait, was the strongest negative predictor of outcome in ICT and IGCT both at post-treatment and 1-year follow-up. Whereas low SD, signs of cluster C personality disorder and fear of negative evaluation were negative predictors of post-treatment outcome in ICT, the corresponding pattern of results was not to be found in IGCT. CONCLUSIONS Anticipatory worry appears to be a particularly important trait for explaining variance in the outcome of social phobia. The finding is consistent with the assumed stability of such personality traits over time. Further studies are warranted to replicate the finding.
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Affiliation(s)
- Ewa Mörtberg
- Department of Psychology, Stockholm University, Sweden; Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
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17
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Dalbudak E, Evren C, Aldemir S, Coskun KS, Yıldırım FG, Ugurlu H. Alexithymia and personality in relation to social anxiety among university students. Psychiatry Res 2013; 209:167-72. [PMID: 23246382 DOI: 10.1016/j.psychres.2012.11.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 11/11/2012] [Accepted: 11/12/2012] [Indexed: 11/24/2022]
Abstract
The aims of the present study were to investigate the relationship of social anxiety symptoms with alexithymia and personality dimensions in university students and to control the effects of depression and anxiety on this relationship. A total of 319 university students (85 males and 234 females) from two different universities in Ankara were investigated with the Liebowitz Social Anxiety Scale (LSAS), the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Toronto Alexithymia Scale (TAS-20) and the Temperament and Character Inventory (TCI). We found that subscales of the LSAS (fear or anxiety and avoidance) were positively correlated with depression and alexithymia and "difficulty in identifying feelings" (DIF) and "difficulty in describing feelings" (DDF) subscales of the TAS-20. Harm avoidance (HA) showed positive correlations with subscales of the LSAS, whereas self-directedness (SD) showed negative correlations with these subscales. High TAS-20 DDFand HA and low SD predicted fear or anxiety LSAS subscale scores, whereas high TAS-20 DDF, HA and depression scores were predictors for LSAS avoidance subscale scores. Although our sample is not representative of the whole Turkish university student population, we conclude that both fear or anxiety and avoidance were mainly interrelated with DDF and HA, although the causal relationship is not clear.
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Affiliation(s)
- Ercan Dalbudak
- Department of Psychiatry, Faculty of Medicine, Fatih University, Ankara, Turkey.
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18
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Adherence to the Mediterranean dietary pattern and personality in patients attending a primary health center. J Acad Nutr Diet 2012; 112:887-91. [PMID: 22709815 DOI: 10.1016/j.jand.2012.02.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 02/08/2012] [Indexed: 11/23/2022]
Abstract
Personality influences lifestyle behaviors, and particularly dietary behavior. The possible association of personality with adherence to the Mediterranean diet pattern (MDP) has not been reported. The objective of this study was to analyze the possible association of personality traits with adherence to the MDP, controlling for sociodemographic variables, presence of chronic illnesses, minor psychiatric morbidity, body mass index (BMI), daily smoking, and physical activity. This cross-sectional study included 206 patients, age 18 to 65 years, recruited at a primary health service in Granada, Spain, during 2007 to 2008. The participants answered a questionnaire, including sociodemographic characteristics, data on personality, and MDP. Personality was measured by the Temperament and Character Inventory (TCI-125). Adherence to MDP was measured using the validated 14-point Mediterranean Diet Adherence Screener (MEDAS). MEDAS score was directly associated with the character dimension of self-directedness, age, and minor psychiatric morbidity score; and inversely with marital status (widowed, separated, or divorced) and BMI. Because highly self-directed individuals may respond better to diet advice, consideration of personality may prove helpful in the design of interventions to enhance the adherence to MDP. To improve the adherence to MDP in interventions with patients with low self-directedness, more intensive professional support and counseling with tailored messages about the health benefits of MDP may be indicated.
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Agüera Z, Krug I, Sánchez I, Granero R, Penelo E, Peñas-Lledó E, Jiménez-Murcia S, Menchón JM, Fernández-Aranda F. Personality changes in bulimia nervosa after a cognitive behaviour therapy. EUROPEAN EATING DISORDERS REVIEW 2012; 20:379-85. [PMID: 22367847 DOI: 10.1002/erv.2163] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The goals of this study were to evaluate changes in personality traits in outpatients with bulimia nervosa and specific clinical predictors of such personality changes, after cognitive behaviour therapy (CBT). METHOD The sample comprised 100 purging bulimia nervosa outpatients (DSM-IV-TR). Assessment measures included the Eating Disorders Inventory-2, Symptom Check List Revised and Temperament and Character Inventory-Revised, as well as other clinical and psychopathological indices. All measures were administered before and after 22 weeks of group CBT. RESULTS The temperament traits of Harm Avoidance and Reward Dependence and the character traits of Self-Directedness and Self-Transcendence changed after CBT. Pre-post CBT reduction in Eating Disorders Inventory-2 total score predicted the decrease and increase in Harm Avoidance and Self-Directedness, respectively. CONCLUSIONS Results suggest that group CBT in outpatient women settings influence changes in some personality traits, which appear mainly related to an overall improvement in eating pathology.
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Affiliation(s)
- Zaida Agüera
- CIBER Fisiología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Spain
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20
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Rapee RM, Coplan RJ. Conceptual relations between anxiety disorder and fearful temperament. New Dir Child Adolesc Dev 2012; 2010:17-31. [PMID: 20205179 DOI: 10.1002/cd.260] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Fearful temperaments have been identified as a major risk factor for anxiety disorders. However, descriptions of fearful temperament and several forms of anxiety disorder show strong similarities. This raises the question whether these terms may simply refer to different aspects of the same underlying construct. The current review examines evidence for the overlap and distinction between these constructs. Although strong conclusions cannot be drawn from the extant literature, the bulk of the evidence appears to support a distinction between them.
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Affiliation(s)
- Ronald M Rapee
- Department of Psychology, and Centre for Emotional Health, Macquarie University in Australia
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21
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Effects of temperament and character profiles on state and trait depression and anxiety: a prospective study of a Japanese youth population. DEPRESSION RESEARCH AND TREATMENT 2012; 2012:604684. [PMID: 22957225 PMCID: PMC3432344 DOI: 10.1155/2012/604684] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 07/02/2012] [Indexed: 11/17/2022]
Abstract
Objective. To examine the effects of temperament and character profiles on state and trait depression and anxiety in a Japanese youth population. Method. Japanese university students were solicited for participation in a two-wave study, with assessments performed at Time 1 (T1) and Time 2 (T2), separated by a five-month interval. A total of 184 students completed the Japanese version of the temperament and character inventory (TCI) at T1 and the Hospital Anxiety and Depression Scale (HADS) at T1 and T2. We posited two latent variables, trait depression and anxiety, composed of the T1 and T2 HADS depression and anxiety scores, respectively. We also posited that temperament domain traits would predict character domain traits, and that all the personality traits would be linked to trait depression and anxiety and also predict T2 depression and anxiety. Results. Structural regression modeling showed that (1) only high Novelty Seeking predicted T2 Anxiety score, (2) trait depression and anxiety were linked to high harm avoidance and low self-directedness, and (3) trait depression was linked to high self-transcendence whereas trait anxiety was linked to low reward dependence, persistence, and cooperativeness. Conclusion. The characteristic associations between TCI subscales and depression and anxiety were limited to the trait rather than state aspects of depression and anxiety.
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Almeida KM, Nery FG, Moreno RA, Gorenstein C, Lafer B. Personality traits in bipolar disorder type I: a sib-pair analysis. Bipolar Disord 2011; 13:662-9. [PMID: 22085479 DOI: 10.1111/j.1399-5618.2011.00965.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of this study was to compare temperament and character traits among patients with bipolar disorder (BD), their siblings, and healthy controls (HCs) in order to examine whether personality traits are related to the genetic vulnerability to develop BD. METHODS Using the Temperament and Character Inventory, we assessed 204 subjects: 67 euthymic outpatients with bipolar disorder type I, 67 siblings without BD, and 70 HCs. RESULTS Scores on harm avoidance, novelty seeking, and self-transcendence were significantly higher among patients with BD than among HCs, whereas those on self-directedness and cooperativeness were significantly lower. Siblings showed higher scores on harm avoidance and lower scores on self-directedness than did HCs. As some of the siblings presented at least one lifetime psychiatric disorder other than BD (n = 35), we examined the subset of siblings who had no lifetime psychiatric disorder (n = 32). This group showed statistically higher harm avoidance scores than HCs. CONCLUSIONS Our results suggest that the harm avoidance temperament trait and, to a lesser extent, the self-directedness character trait may represent vulnerability factors for BD.
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Affiliation(s)
- Karla Mathias Almeida
- Bipolar Disorder Research Program, University of São Paulo School of Medicine, São Paulo, Brazil.
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Du Preez E, Cassimjee N, Lauritz LE, Ghazinour M, Richter J. Personality and mental health: an investigation of South African police trainees. Psychol Rep 2011; 108:301-16. [PMID: 21526614 DOI: 10.2466/02.09.10.20.pr0.108.1.301-316] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The relationship between personality and mental health was investigated in one cohort of police trainees at a South African police academy (1145 police recruits; 648 men, 497 women). Male trainees reported less somatisation, depression, anxiety, and phobic anxiety symptoms and lower harm avoidance as well as higher persistence than female trainees. A cluster analysis based on the personality scores was used to identify three clusters with personality profiles characterized as Vulnerable, Healthy, and Intermediate profiles. Sociodemographic variables and temperament and character domain scores contributed separately and differentially to the explanation of variance in mental health symptom scores. Selection tools should be developed to identify vulnerable individuals in terms of personality characteristics during selection and prior to training, to prevent later problems with stress reactions. Additional training modules focusing on coping skills could possibly reduce vulnerability to stress in some trainees.
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Affiliation(s)
- E Du Preez
- Auckland University of Technology, Auckland, New Zealand
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Roussos P, Giakoumaki SG, Georgakopoulos A, Robakis NK, Bitsios P. The CACNA1C and ANK3 risk alleles impact on affective personality traits and startle reactivity but not on cognition or gating in healthy males. Bipolar Disord 2011; 13:250-9. [PMID: 21676128 DOI: 10.1111/j.1399-5618.2011.00924.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The rs10994336 ANK3 and rs1006737 CACNA1C genetic variants have recently been identified as the most consistent, genome-wide significant risk factors for bipolar disorder, while the CACNA1C variant has also been associated with schizophrenia and major depression. The aim of this study was to examine the phenotypic consequences of the risk CACNA1C and ANK3 alleles in a large homogeneous cohort of healthy young males. METHODS We recruited 703 randomly selected, healthy army conscripts (mean age 22.1 ± 3.0 years) from the first wave of the Learning on Genetics of Schizophrenia project in Heraklion, Crete. Of those recruited, 530 subjects entered and completed the study. Subjects were assessed for prepulse inhibition (PPI), startle reactivity, neuropsychology, and personality. RESULTS UNPHASED analysis revealed that the rs1006737 A-allele was associated with lower extraversion and higher harm avoidance, trait anxiety, and paranoid ideation, while the rs10994336 T-allele was associated with lower novelty seeking and behavioral activation scores (p < 0.01). Both alleles were associated with high startle reactivity (p < 0.05). There were no significant associations with any cognitive task performance or PPI. CONCLUSIONS The CACNA1C genotype was associated with proneness to anxiety and negative mood, while the ANK3 genotype was associated with proneness to anhedonia. Both risk genotypes were associated with high startle reactivity, suggesting a role of these polymorphisms in threat/stress signal processing, probably in the hippocampus and/or amygdala. None of the risk genotypes affected sensorimotor gating or behavioral performance in an extensive battery of executive function tests in this cohort of healthy males.
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Affiliation(s)
- Panos Roussos
- Department of Psychiatry and Behavioral Sciences, University of Crete, Heraklion, Greece.
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Dimensional measures of personality as a predictor of outcome at 5-year follow-up in women with bulimia nervosa. Psychiatry Res 2011; 185:414-20. [PMID: 20692708 DOI: 10.1016/j.psychres.2010.07.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 07/13/2010] [Accepted: 07/16/2010] [Indexed: 11/22/2022]
Abstract
Dimensional models are commonly used as a supplement to the categorical model within the field of personality disorders. The purpose of this study was to examine personality dimensions as predictors of 5-year outcomes among women with bulimia nervosa. One hundred and thirty-four women with bulimia nervosa participated in a randomised psychotherapy treatment trial. Data was available for 109 out of the 134 participants at follow-up. Outcomes were the presence of any eating disorder (past year), the presence of a mood disorder episode (past year), and the global assessment of functioning at 5-year follow-up. Self-directedness was the only predictor of any eating disorder diagnosis (past year) at 5-year follow-up. Asceticism significantly predicted the presence of a mood disorder episode (past year) at 5 years. Borderline personality disorder symptoms predicted global functioning at 5 years. These results suggest that high self-directedness at pre-treatment may offer potential prognostic information regarding eating disorder status 5 years post-treatment. Furthermore, no single measure predicted outcome for all variables (any eating disorder diagnosis, a mood disorder episode (past year), or global functioning) at 5-year follow-up. This suggests that a comprehensive personality assessment using multiple measures is desirable for predicting outcomes.
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Gibbon S, Duggan C, Stoffers J, Huband N, Völlm BA, Ferriter M, Lieb K. Psychological interventions for antisocial personality disorder. Cochrane Database Syst Rev 2010:CD007668. [PMID: 20556783 PMCID: PMC4167848 DOI: 10.1002/14651858.cd007668.pub2] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Antisocial personality disorder (AsPD) is associated with a wide range of disturbance including persistent rule-breaking, criminality, substance use, unemployment, homelessness and relationship difficulties. OBJECTIVES To evaluate the potential beneficial and adverse effects of psychological interventions for people with AsPD. SEARCH STRATEGY Our search included CENTRAL Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycINFO, ASSIA, BIOSIS and COPAC. SELECTION CRITERIA Prospective, controlled trials in which participants with AsPD were randomly allocated to a psychological intervention and a control condition (either treatment as usual, waiting list or no treatment). DATA COLLECTION AND ANALYSIS Three authors independently selected studies. Two authors independently extracted data. We calculated mean differences, with odds ratios for dichotomous data. MAIN RESULTS Eleven studies involving 471 participants with AsPD met the inclusion criteria, although data were available from only five studies involving 276 participants with AsPD. Only two studies focused solely on an AsPD sample. Eleven different psychological interventions were examined. Only two studies reported on reconviction, and only one on aggression. Compared to the control condition, cognitive behaviour therapy (CBT) plus standard maintenance was superior for outpatients with cocaine dependence in one study, but CBT plus treatment as usual was not superior for male outpatients with recent verbal/physical violence in another. Contingency management plus standard maintenance was superior for drug misuse for outpatients with cocaine dependence in one study but not in another, possibly because of differences in the behavioural intervention. However, contingency management was superior in social functioning and counselling session attendance in the latter. A multi-component intervention utilising motivational interviewing principles, the 'Driving Whilst Intoxicated program', plus incarceration was superior to incarceration alone for imprisoned drink-driving offenders. AUTHORS' CONCLUSIONS Results suggest that there is insufficient trial evidence to justify using any psychological intervention for adults with AsPD. Disappointingly few of the included studies addressed the primary outcomes defined in this review (aggression, reconviction, global functioning, social functioning, adverse effects). Three interventions (contingency management with standard maintenance; CBT with standard maintenance; 'Driving Whilst Intoxicated program' with incarceration) appeared effective, compared to the control condition, in terms of improvement in at least one outcome in at least one study. Each of these interventions had been originally developed for people with substance misuse problems. Significant improvements were mainly confined to outcomes related to substance misuse. No study reported significant change in any specific antisocial behaviour. Further research is urgently needed for this prevalent and costly condition.
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Affiliation(s)
- Simon Gibbon
- St Andrew’s Healthcare, Northampton, & Section of Forensic Mental Health, Institute of Mental Health, Nottingham, UK
| | - Conor Duggan
- Section of Forensic Mental Health, Institute of Mental Health, Nottingham, UK
| | - Jutta Stoffers
- Department of Psychiatry and Psychotherapy, Freiburg, & Department of Psychiatry and Psychotherapy, Mainz, Germany
| | - Nick Huband
- Section of Forensic Mental Health, Institute of Mental Health, Nottingham, UK
| | - Birgit A Völlm
- Section of Forensic Mental Health, Institute of Mental Health, Nottingham, UK
| | - Michael Ferriter
- Literature and Evidence Research Unit (LERU), Institute of Mental Health, Nottinghamshire Healthcare NHS Trust, Woodbeck, UK
| | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
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Adan A, Lachica J, Caci H, Natale V. CIRCADIAN TYPOLOGY AND TEMPERAMENT AND CHARACTER PERSONALITY DIMENSIONS. Chronobiol Int 2010; 27:181-93. [DOI: 10.3109/07420520903398559] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Premorbid personality in chronic fatigue syndrome as determined by the Temperament and Character Inventory. Compr Psychiatry 2010; 51:78-85. [PMID: 19932830 DOI: 10.1016/j.comppsych.2009.02.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 01/30/2009] [Accepted: 02/02/2009] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Using the Temperament and Character Inventory (TCI), we examined personality characteristics in patients with chronic fatigue syndrome (CFS) compared with healthy control subjects, and CFS patients with and without psychiatric diseases. There have been no previous reports assessing personality in CFS patients using the TCI. METHODS A total of 211 CFS patients and 90 control subjects completed the TCI and the Chalder Fatigue Scale questionnaires. RESULTS Compared with control subjects, CFS patients demonstrated significantly lower premorbid Novelty Seeking, and higher Harm Avoidance and persistence. The fatigue score for CFS patients with psychiatric diseases was higher than that for CFS patients without psychiatric diseases. Patients with CFS with psychiatric diseases showed lower premorbid Self-Directedness when compared with CFS patients without psychiatric diseases. The fatigue score was negatively correlated with premorbid Self-Directedness and Cooperativeness, and positively correlated with Harm Avoidance among CFS patients. CONCLUSION This study supported the stereotyped image of CFS patients as perfectionists, which is similar to the Persistence score, and neurotics, which is similar to the Harm Avoidance score. Patients displaying greater neuroticisms and poorer social and communication skills, similar to the Self-Directedness and Cooperativeness scores, tend to have intercurrent psychiatry diseases and show more severe symptoms of CFS.
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Effects of paroxetine on emotional functioning and treatment awareness: a 4-week randomized placebo-controlled study in healthy clinicians. Psychopharmacology (Berl) 2010; 207:619-29. [PMID: 19826792 DOI: 10.1007/s00213-009-1691-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2009] [Accepted: 09/28/2009] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The objective of our study was to evaluate the effects of paroxetine on emotional functioning in three arms: double-blind paroxetine (DBPX), single-blind paroxetine (SBPX), and double-blind placebo (DBPO). Healthy psychologists and psychiatrists were elected for their ability to analyze with correct sensibility changes in their emotions. METHOD Thirty nonanxious, nondepressed participants working as psychiatrists (N = 18) or psychologists (N = 12) were randomly assigned to receive an ambulatory treatment with paroxetine (DBPX N = 10, SBPX N = 10) or placebo (DBPO N = 10). Paroxetine was administered for 4 weeks at 20 mg/day. Emotional functioning was evaluated with the Emotional State Questionnaire (ESQ), a self-questionnaire designed to assess four emotional dimensions: "recognition," "expression," "internal emotional experience," and "social context." Changes in emotional measures from baseline to D0, D7, D14, D28, and D42 were compared between treatment groups. RESULTS Analyses of ESQ showed in DBPX a significant decrease from baseline to D28 in internal emotional experience as compared to SBPX and DBPO groups. A different influence of gender between treatment groups on emotional recognition was observed. CONCLUSIONS This is the first study assessing the impact of a 4-week paroxetine treatment on emotional functioning in healthy psychiatrists and psychologists. The DBPX group was distinguishable from both SBPX and DBPO groups by a decrease in internal emotional experience, suggesting that two factors could be involved in the clinical response to paroxetine: a decrease in emotional feeling and treatment awareness.
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Gurpegui M, Jurado D, Fernández-Molina MC, Moreno-Abril O, Luna JD, Alarcón RD. Personality profiles and minor affective psychopathology in a non-clinical sample: an empirical verification of Cloninger's theoretical model. J Affect Disord 2009; 119:34-42. [PMID: 19344955 DOI: 10.1016/j.jad.2009.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Revised: 02/23/2009] [Accepted: 03/03/2009] [Indexed: 11/29/2022]
Abstract
BACKGROUND Psychopathological vulnerability may be related to certain personality traits. The aim of this study was to explore the association of minor affective psychopathology and the regular use of psychotropic medication with temperament and character profiles from Cloninger's personality model, in a sample of active professional people. METHODS This cross-sectional study included 498 non-clinical subjects, teachers in a local school system. Instruments used included the self-administered General Health Questionnaire (GHQ-28) to measure psychiatric morbidity; the Center for Epidemiologic Studies Depression scale (CES-D) to measure depressive symptoms; documentation of regular use of psychotropic medication; and the Temperament and Character Inventory (TCI-125) for personality traits self-assessment. RESULTS The proportion of subjects presenting psychiatric morbidity (GHQ-28>6) or depressive symptoms (CES-D>20) was significantly higher among explosive, passive-aggressive, and obsessional temperament profiles, and among schizotypal, moody, melancholic and dependent character profiles. Similar results were observed with the scores on each of the four GHQ-28 subscales (depression, anxiety, social dysfunction, and somatic symptoms). The regular use of psychotropic medications was significantly higher among the passive-aggressive and explosive temperament types, and among the schizoptypal and moody character types. LIMITATIONS Being a cross-sectional study, no causal attributions can be inferred. Subjects on sick leave were excluded, so the sample was not representative of the general population. The data were collected using self-reporting questionnaires, and no specific psychiatric diagnoses were obtained. CONCLUSIONS It is possible to identify certain personality configurations associated with minor psychopathology and concomitant use of psychotropics, among active professional people.
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Affiliation(s)
- Manuel Gurpegui
- Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, Center for Biomedical Research (CIBM), University of Granada, Granada, Spain
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Conrad R, Wegener I, Imbierowicz K, Liedtke R, Geiser F. Alexithymia, temperament and character as predictors of psychopathology in patients with major depression. Psychiatry Res 2009; 165:137-44. [PMID: 19084277 DOI: 10.1016/j.psychres.2007.10.013] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2007] [Revised: 10/19/2007] [Accepted: 10/24/2007] [Indexed: 11/24/2022]
Abstract
The study investigated the capacity of alexithymic personality features, in combination with temperament and character traits, age and gender, to predict psychopathological symptoms in patients with major depression. Consecutive patients (n=339) were investigated using the Toronto Alexithymia Scale-20 (TAS-20), the Temperament and Character Inventory (TCI), the Symptom Checklist-90-R (SCL-90-R), and the Hamilton Depression and Anxiety Rating Scales (HDRS, HARS). The amount of variance in SCL-90-R subscales and Hamilton scales predicted by TAS-20, TCI, age and gender was calculated by linear regression analyses. The 'difficulties identifying feeling' facet of alexithymia appeared to be a significant predictor of all dimensions of psychopathology. Among TCI scales harm avoidance was the strongest predictor for somatization, phobic anxiety, and anxiety (SCL-90-R, HARS); low self-directedness was the strongest predictor for obsessionality, depression (SCL-90-R, HDRS), interpersonal sensitivity and psychoticism; and low cooperativeness was the strongest predictor for hostility and paranoia. In conclusion, many psychopathological symptoms in major depression are associated with difficulties in the identification of emotions. Relative to alexithymia, Cloninger's psychobiological model of personality could predict psychopathological symptoms in a distinct and meaningful manner. The TAS-20 and the TCI are useful questionnaires for a better understanding of the relationship between psychopathology and personality in major depression.
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Affiliation(s)
- Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Sigmund Freud Str. 25, 53105 Bonn, Germany.
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Kristensen AS, Mortensen EL, Mors O. The association between bodily anxiety symptom dimensions and the scales of the Revised NEO Personality Inventory and the Temperament and Character Inventory. Compr Psychiatry 2009; 50:38-47. [PMID: 19059512 DOI: 10.1016/j.comppsych.2008.06.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2007] [Revised: 06/02/2008] [Accepted: 06/10/2008] [Indexed: 11/19/2022] Open
Abstract
The association between anxiety disorders and different measures of personality has been extensively studied to further the understanding of etiology, course, and treatment, and to possibly prevent the development of anxiety disorders. We have proposed a hierarchical model of bodily anxiety symptoms with 1 second-order severity factor and 5 first-order factors: cardio-respiratory, gastro-intestinal, autonomic, vertigo, and tension. The aim of this study was to investigate whether personality traits were differentially related to distinct symptom subdimensions or exclusively related to the general severity factor. Structural equation modeling of data on 120 patients with a primary diagnosis of social phobia and 207 patients with a primary diagnosis of panic disorder was used to examine the association between anxiety symptom dimensions and the scales of the Temperament and Character Inventory and of the Revised NEO Personality Inventory. When both sets of personality measures were simultaneously modeled as predictors, the Revised NEO Personality Inventory scales, neuroticism and extraversion, remained significantly associated with the severity factor, whereas the association between the Temperament and Character Inventory dimensions, harm avoidance and novelty seeking, and the severity factor became nonsignificant. Harm avoidance was negatively associated with the vertigo first-order factor, whereas neuroticism was negatively associated with the cardio-respiratory first-order factor, indicating that personality factors may be differentially related to specific anxiety subdimensions.
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Affiliation(s)
- Ann Suhl Kristensen
- Centre for Psychiatric Research, Aarhus University Hospital, 8240 Risskov, Denmark.
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Hirshfeld-Becker DR, Micco JA, Simoes NA, Henin A. High risk studies and developmental antecedents of anxiety disorders. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2008; 148C:99-117. [DOI: 10.1002/ajmg.c.30170] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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