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Penders KAP, Rossi G, Debast I, Segal DL, Peeters IGP, Metsemakers JFM, van Alphen SPJ. Personality disorders in older adults: Differences in self-informant ratings. Personal Ment Health 2024; 18:32-42. [PMID: 37784213 DOI: 10.1002/pmh.1592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/27/2023] [Accepted: 09/16/2023] [Indexed: 10/04/2023]
Abstract
Previous research on self-informant reports in assessing personality disorders (PDs) has been mainly focused on adults, leaving older adults under-studied. We examined self-informant agreement in PD screening among older adults (≥60 years) using the Gerontological Personality disorders Scale (GPS). Potential differences such as who reports more personality pathology on a PD screener (i.e., GPS), item accessibility and the effect of relational aspects were studied as well. Data of 326 older adult-informant dyads, of which the older adults were sampled from five general practices in the Netherlands, were used. Results indicate that self-informant agreement ranged from r = 0.26-0.73, with lower concordance on the GPS-subscale measuring intrapersonal aspects of personality pathology. Informants were more sensitive to habitual pathological personality features than older adults. Two GPS items showed differential item functioning across self- and informant-report. Of relational aspects, only congeniality affected the GPS-iv scores; lower ratings on congeniality were associated with higher GPS-iv scores (i.e., higher reporting of personality problems).
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Affiliation(s)
- Krystle A P Penders
- Faculty of Psychology and Educational Sciences, Department of Clinical and Lifespan Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Treatment and Guidance, Envida, Maastricht, The Netherlands
| | - Gina Rossi
- Faculty of Psychology and Educational Sciences, Department of Clinical and Lifespan Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Inge Debast
- Faculty of Psychology and Educational Sciences, Department of Clinical and Lifespan Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Daniel L Segal
- Department of Psychology, University of Colorado, Colorado Springs, Colorado, USA
| | - Inge G P Peeters
- Department of Family Medicine, School CAPHRI, Care and Public Health Research Institute, Maastricht University (UM), Maastricht, The Netherlands
- Academy for Postgraduate Medical Training, Maastricht University Medical Centre+ (MUMC+), Maastricht, The Netherlands
| | - Job F M Metsemakers
- Department of Family Medicine, School CAPHRI, Care and Public Health Research Institute, Maastricht University (UM), Maastricht, The Netherlands
| | - Sebastiaan P J van Alphen
- Department of Old Age Psychiatry, Mondriaan Hospital, Heerlen, The Netherlands
- School of Social and Behavioral Sciences, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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Kredentser MS, Mackenzie CS, McClement SE, Enns MW, Hiebert-Murphy D, Murphy DJ, Chochinov HM. Neuroticism as a moderator of symptom-related distress and depression in 4 noncancer end-of-life populations. Palliat Support Care 2023:1-9. [PMID: 37734916 DOI: 10.1017/s147895152300127x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
OBJECTIVES Neuroticism is a significant predictor of adverse psychological outcomes in patients with cancer. Less is known about how this relationship manifests in those with noncancer illness at the end-of-life (EOL). The objective of this study was to examine the impact of neuroticism as a moderator of physical symptoms and development of depression in patients with amyotrophic lateral sclerosis (ALS), chronic obstructive pulmonary disease (COPD), end-stage renal disease (ESRD), and frailty in the last 6 months of life. METHODS We met this objective using secondary data collected in the Dignity and Distress across End-of-Life Populations study. The data included N = 404 patients with ALS (N = 101), COPD (N = 100), ESRD (N = 101), and frailty (N = 102) in the estimated last 6 months of life, with a range of illness-related symptoms, assessed longitudinally at 2 time points. We examined neuroticism as a moderator of illness-related symptoms at Time 1 (∼6 months before death) and depression at Time 2 (∼3 months before death) using ordinary least squares regression. RESULTS Results revealed that neuroticism significantly moderated the relationship between the following symptoms and depression measured 3 months later: drowsiness, fatigue, shortness of breath, wellbeing (ALS); drowsiness, trouble sleeping, will to live, activity (COPD); constipation (ESRD); and weakness and will to live (frailty). SIGNIFICANCE OF RESULTS These findings suggest that neuroticism represents a vulnerability factor that either attenuates or amplifies the relationship of specific illness and depressive symptoms in these noncancer illness groups at the EOL. Identifying those high in neuroticism may provide insight into patient populations that require special care at the EOL.
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Affiliation(s)
- Maia S Kredentser
- Department of Clinical Health Psychology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Corey S Mackenzie
- Department of Psychology, and Adjunct Professor, Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Susan E McClement
- Research, College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Murray W Enns
- Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Diane Hiebert-Murphy
- Faculty of Social Work and the Psychological Service Centre, University of Manitoba, Winnipeg, MB, Canada
| | - Dallas J Murphy
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Harvey M Chochinov
- Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
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Henriques-Calado J, Duarte-Silva ME. Personality disorders characterized by anxiety predict Alzheimer's disease in women: A case-control studies. THE JOURNAL OF GENERAL PSYCHOLOGY 2019; 147:414-431. [PMID: 31833453 DOI: 10.1080/00221309.2019.1697637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This research is geared toward the evaluation of current and pre-morbid personality psychopathology in Alzheimer's disease (AD). The study was conducted with four groups who were administered the Personality Diagnostic Questionnaire-4+, mainly in the form of individual interviews. Current measurement: AD Group, 44 female participants (M = 81.36 years); Control Group, 80 female participants from the population at large (M = 75.84 years). Pre-morbid measurement: AD Group Informants (n = 40); Control Group Informants (n = 42). The incidence of all clusters in clinical state are significant, and Cluster B incidence in pre-morbidity is evidenced. Cluster C is highlighted throughout the life course as a predictor. Logistic regression analyses showed that schizotypical, narcissistic, avoidant, obsessive-compulsive, pre-morbid schizotypical, pre-morbid histrionic, and pre-morbid obsessive-compulsive personality disorders, predicted the presence of AD diagnosis, accounting for 49% of the variance. These findings are relevant to research relating personality and psychopathology in Alzheimer's disease.
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Abstract
Antisocial personality disorder (ASPD) has enormous negative impacts on the affected individuals, their loved ones, and society. This burden is intensified by the social and functional changes related to age. The lower prevalence of ASPD in older adults compared to younger adults is well-documented. This discrepancy, often attributed solely to antisocial "burnout," contributes to the lack of attention given to this disorder in older adults and may signify difficulty measuring ASPD in this population. These measurement issues likely stem from problems with the validity of the diagnostic criteria for older adults which may not effectively capture changes that occur with age. This review focuses on the current literature surrounding the validity of ASPD criteria with older adults and relevant concepts, including the connection between criminality and ASPD. Issues with screening tools and the measurement of ASPD caused by problems with the criteria are also discussed. Finally, recommendations for improvement, including use of dimensional models of personality disorders, a potential geriatric subclassification of criteria, and modification of the existing criteria are presented with clinical implications and suggestions for future research.
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Affiliation(s)
- Katherine J Holzer
- 1 School of Social Work, College for Public Health and Social Justice, Saint Louis University, St Louis, MO, USA
| | - Michael G Vaughn
- 1 School of Social Work, College for Public Health and Social Justice, Saint Louis University, St Louis, MO, USA
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Henriques-Calado J, Duarte-Silva ME, Sousa Ferreira A. Anaclitic personality dimension in women with Alzheimer's disease: Comparison with control groups. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2017.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Beatson J, Broadbear JH, Sivakumaran H, George K, Kotler E, Moss F, Rao S. Missed diagnosis: The emerging crisis of borderline personality disorder in older people. Aust N Z J Psychiatry 2016; 50:1139-1145. [PMID: 27056175 DOI: 10.1177/0004867416640100] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Clinical experience suggests a growing prevalence of borderline personality disorder in aged residential care and psychiatric facilities with attendant difficulties in their management. This paper reviews the literature concerning the prevalence, phenomenology and diagnosis of borderline personality disorder in old age. The aim is to elucidate the phenomenological differences in old age and thus improve identification of the disorder. METHODS A systematic search was conducted using MEDLINE, PubMed, EMBASE and PsycINFO databases, employing the search terms including 'personality disorder', 'borderline personality disorder', 'aged care', 'gerontology', 'geriatric psychiatry' and 'life span'. The search included articles in English involving participants 65+ years. Long-term prospective studies of borderline personality disorder, long-term follow-up studies and studies involving older adults from 50+ years were also examined. RESULTS There is a paucity of literature on borderline personality disorder in the elderly. No diagnostic or rating instruments have been developed for borderline personality disorder in the elderly. The phenomenology of borderline personality disorder in the aged population differs in several respects from that seen in younger adults, causing some of the difficulties in reaching a diagnosis. Escalations of symptoms and maladaptive behaviours usually occur when the diagnosis of borderline personality disorder is either not made or delayed. Improved identification of borderline personality disorder in older patients, together with staff education concerning the phenomenology, aetiology and management of these patients, is urgently needed. CONCLUSION Diagnostic instruments for borderline personality disorder in the elderly need to be developed. In the interim, suggestions are offered concerning patient symptoms and behaviours that could trigger psychiatric assessment and advice concerning management. A screening tool is proposed to assist in the timely diagnosis of borderline personality disorder in older people. Timely identification of these patients is needed so that they can receive the skilled help, understanding and treatment needed to alleviate suffering in the twilight of their lives.
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Affiliation(s)
- Josephine Beatson
- Statewide Service for Personality Disorder, Eastern Health, Ringwood East, VIC, Australia
| | | | - Hemalatha Sivakumaran
- Aged Persons Mental Health Service, Peter James Centre, Eastern Health, Forest Hill, VIC, Australia
| | | | - Eli Kotler
- Aged Psychiatry Service, Caulfield Hospital, Alfred Health, Melbourne, VIC, Australia
| | - Francine Moss
- St Vincent's Aged Persons Mental Health Service, St George's Health Service, Kew, VIC, Australia
| | - Sathya Rao
- Statewide Service for Personality Disorder, Eastern Health, Ringwood East, VIC, Australia
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Henriques-Calado J, Duarte-Silva ME, Campos RC, Junqueira D, Sacoto C, Keong AM. Personality disorders as an expression of the dimensional polarity in personality development in late adulthood women. Bull Menninger Clin 2014; 78:283-300. [PMID: 25495434 DOI: 10.1521/bumc.2014.78.4.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Relationships between Axis II personality disorders and Sidney Blatt constructs of dependency and self-criticism were explored in a late adulthood women sample. The sample consisted of 102 women (M = 72.07 years of age, SD = 7.04) who were administered two measures, the Personality Diagnostic Questionnaire-4+ and the Depressive Experiences Questionnaire. The histrionic, dependent, and obsessive-compulsive personality disorder scales are shown to be significant predictors of dependency, and the narcissistic, borderline, and avoidant scales are significant predictors of self-criticism. The application of a dimensional interpersonal approach to psychopathology is discussed.
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Henriques-Calado J, Duarte-Silva ME, Junqueira D, Sacoto C, Keong AM. Five-factor model personality domains in the prediction of Axis II personality disorders: an exploratory study in late adulthood women non-clinical sample. Personal Ment Health 2014; 8:115-27. [PMID: 24700735 DOI: 10.1002/pmh.1250] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 08/27/2013] [Accepted: 11/18/2013] [Indexed: 11/08/2022]
Abstract
Relationships between Axis II personality disorders (DSM-IV) and the five-factor model were explored in a non-clinical sample of late adulthood women. The sample consists of 90 women (M = 72.29 years of age, standard deviation = 7.10), who were administered with two measures, the NEO-FFI and the Personality Diagnostic Questionnaire-4+. Some personality disorders scales such as paranoid, schizotypal, borderline and dependent demonstrate a differentiated pattern of five-factor model domain predictors. Low agreeableness predicted schizoid, narcissistic and antisocial; histrionic, obsessive-compulsive and negativistic were predicted by high neuroticism and low agreeableness; high neuroticism and low extraversion, in turn, predicted dependent and depressive scales. Also, two clusters of personality disorders are identified, one associated with low agreeableness and another with low agreeableness and high neuroticism. This study suggest that some traits become maladaptive personality traits, and correspond more closely to psychopathology, when they become opposite to what would be expected in line with studies in normal late adulthood development.
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Affiliation(s)
- Joana Henriques-Calado
- Faculty of Psychology-University of Lisbon, Alameda da Universidade 1649-013, Lisbon, Portugal
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Henriques-Calado J, Duarte-Silva ME, Keong AM, Sacoto C, Junqueira D. Personality traits and personality disorders in older women: an explorative study between normal development and psychopathology. Health Care Women Int 2013; 35:1303-14. [PMID: 24236663 DOI: 10.1080/07399332.2013.841697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The relationships between Axis II personality disorders (DSM-IV) and the Five-Factor Model (FFM) were explored in older women. The sample consists of 90 participants (M = 72.29 years, SD = 7.10) who were administered the NEO-Five-Factor Inventory and the Personality Diagnostic Questionnaire. The highest prevalence of A and C clusters and obsessive-compulsive personality disorder was observed. Also, elevated neuroticism and decreased agreeableness and openness appear as valuable traits in the description of psychopathology. The study of maladaptive personality functioning within an aging population can be described with the same traits that underlie normal personality functioning, extending the range of psychopathology to a dimensional approach.
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Henriques-Calado J, Duarte-Silva ME, Campos RC, Sacoto C, Keong AM, Junqueira D. Predicting relatedness and self-definition depressive experiences in aging women based on personality traits: a preliminary study. Bull Menninger Clin 2013; 77:269-88. [PMID: 24020611 DOI: 10.1521/bumc.2013.77.3.269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
As part of the research relating personality and depression, this study seeks to predict depressive experiences in aging women according to Sidney Blatt's perspective based on the Five-Factor Model of Personality. The NEO-Five Factor Inventory and the Depressive Experiences Questionnaire were administered. The domains Neuroticism, Agreeableness, and Conscientiousness predicted self-criticism, explaining 68% of the variance; the domains Neuroticism and Extraversion predicted dependency, explaining 62% of the variance. The subfactors Neediness and Connectedness were differently related to personality traits. These findings are relevant to the research relating personality and anaclitic / introjective depressive experiences in late adulthood.
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11
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Helmes E, Norton MC, Østbye T. Personality change in older adults with dementia: Occurrence and association with severity of cognitive impairment. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/aar.2013.21004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Salavera C, Tricás JM, Lucha O. Personality disorders and psychosocial problems in a group of participants to therapeutic processes for people with severe social disabilities. BMC Psychiatry 2011; 11:192. [PMID: 22151623 PMCID: PMC3252283 DOI: 10.1186/1471-244x-11-192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Accepted: 12/11/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Homeless people have high dropout rates when they participate in therapeutic processes. The causes of this failure are not always known. This study investigates whether dropping-out is mediated by personality disorders or whether psychosocial problems are more important. METHOD Eighty-nine homeless people in a socio-laboral integration process were assessed. An initial interview was used, and the MCMI II questionnaire was applied to investigate the presence of psychosocial disorders (DSM-IV-TR axis IV). This was designed as an ex post-facto prospective study. RESULTS Personality disorders were very frequent among the homeless people examined. Moreover, the high index of psychosocial problems (axis IV) in this population supported the proposal that axis IV disorders are influential in failure to complete therapy. CONCLUSION The outcomes of the study show that the homeless people examined presented with more psychopathological symptoms, in both axis II and axis IV, than the general population. This supports the need to take into account the comorbidity between these two types of disorder among homeless people, in treatment and in the development of specific intervention programs. In conclusion, the need for more psychosocial treatments addressing the individual problems of homeless people is supported.
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Affiliation(s)
- Carlos Salavera
- Departament de Psychology and Sociology. Education Faculty, Zaragoza University, C/San Juan Bosco, 7. 50009 Zaragoza, Spain
| | - José M Tricás
- Physiotherapy Research Unit, Zaragoza University, C/Domingo Miral s/n, 50009 Zaragoza, Spain
| | - Orosia Lucha
- Physiotherapy Research Unit, Zaragoza University, C/Domingo Miral s/n, 50009 Zaragoza, Spain
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Oltmanns TF, Balsis S. Personality disorders in later life: questions about the measurement, course, and impact of disorders. Annu Rev Clin Psychol 2011; 7:321-49. [PMID: 21219195 DOI: 10.1146/annurev-clinpsy-090310-120435] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Lifespan perspectives have played a crucial role in shaping our understanding of many forms of psychopathology. Unfortunately, little attention has been given to personality disorders in middle adulthood and later life. Several issues are responsible for this deficiency, including difficulty applying the diagnostic criteria for personality disorders to older people and challenges in identifying appropriate samples of older participants. The goal of this review is to explore the benefits of considering older adults in the study of personality disorders. Later life offers a unique opportunity for investigators to consider links between personality pathology and consequential outcomes in people's lives. Many domains are relevant, including health, longevity, social adjustment, marital relationships, and the experience of major life events. We review each domain and consider ways in which the study of middle-aged and older adults challenges researchers to evaluate how personality disorders in general are defined and measured.
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Affiliation(s)
- Thomas F Oltmanns
- Department of Psychology, Washington University in St. Louis, St. Louis, Missouri 63130-4899, USA.
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Van den Broeck J, Rossi G, Dierckx E. [Assessment of personality and personality pathology in older persons]. Tijdschr Gerontol Geriatr 2010; 41:68-77. [PMID: 20443283 DOI: 10.1007/bf03096185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Compared to other domains in personality research, research on personality and personality pathology in the elderly is still in its infancy. However, with the growing proportion of older people in the population, the interest in this topic has increased sharply in the past years. Nevertheless, our knowledge about this domain remains relatively limited. Researchers in this domain are facing several challenges. On the one hand, little is known about the course of personality and psychopathology in later life, because longitudinal studies are scarce or non-existent. On the other hand, both clinical practice and the research literature indicate a growing demand for reliable and valid instruments for the assessment of personality in the elderly. In this article we discuss the main conceptual and methodological issues, as well as recent evolutions concerning this research domain in the Netherlands and Flanders.
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Affiliation(s)
- J Van den Broeck
- Vrije Universiteit Brussel, Faculteit Psychologie en Educatiewetenschappen, Vakgroep Klinische en Levensloop Psychologie, Pleinlaan 2, 1050 Brussel.
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Trouillet R, Gély-Nargeot MC. Mécanismes de défense et dépression du sujet âgé institutionnalisé. ANNALES MEDICO-PSYCHOLOGIQUES 2009. [DOI: 10.1016/j.amp.2006.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Burkhardt H, Wehling M, Gladisch R. Prävention unerwünschter Arzneimittelwirkungen bei älteren Patienten. Z Gerontol Geriatr 2007; 40:241-54. [PMID: 17701115 DOI: 10.1007/s00391-007-0468-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2007] [Accepted: 07/18/2007] [Indexed: 11/25/2022]
Abstract
Adverse drug reactions are among the most common adverse events and a significant cause of preventable morbidity and mortality. As multimorbidity and polypharmacy are frequent in this population, the elderly are at special risk for adverse drug events, although the calendar age has not been proved as independent risk factor in this context. In particular falls and delirium are clinically significant and typical adverse drug events in the elderly. In this review mechanisms and factors which determine adverse drug re actions are described, and possible strategies for an effective prevention are given. This covers pharmacokinetic, pharmacogenetic and pharmacodynamic aspects as well as factors influencing individual adherence to drug therapy. A significant portion of adverse drug reaction may be prevented by a thorough indication and prudent monitoring of pharmacotherapy. Also adherence to pharmacotherapy may be improved by tailored and individual means referring to the patient's needs and expectancies. In the elderly functional limitations such as reduced cognitive abilities, reduced visual acuity and impaired dexterity determine an ineffective pharmacotherapy and medication errors. Hereby these functional limitations are significant predictors of adverse drug events in the context of self-management of pharmacotherapy. Testing of functional abilities as provided in the geriatric assessment is helpful to identify these factors. Among altered pharmacokinetic factors in the elderly, reduced renal function is most important to avoid overdosage. Although a precise measurement of renal function is not possible in a bed-side manner, an estimation of actual renal function utilizing estimation-formulas should always take place.
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Affiliation(s)
- H Burkhardt
- Universität Heidelberg, Medizinische Fakultät Mannheim, IV. Medizinische Klinik, Schwerpunkt Geriatrie und Zentrum für Gerontopharmakologie, Universitätsklinikum Mannheim, 68135, Mannheim, Germany.
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Neuroanatomical correlates of personality in the elderly. Neuroimage 2007; 35:263-72. [PMID: 17229578 DOI: 10.1016/j.neuroimage.2006.11.039] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2006] [Revised: 11/08/2006] [Accepted: 11/09/2006] [Indexed: 10/23/2022] Open
Abstract
Extraversion and neuroticism are two important and frequently studied dimensions of human personality. They describe individual differences in emotional responding that are quite stable across the adult lifespan. Neuroimaging research has begun to provide evidence that neuroticism and extraversion have specific neuroanatomical correlates within the cerebral cortex and amygdala of young adults. However, these brain areas undergo alterations in size with aging, which may influence the nature of these personality factor-brain structure associations in the elderly. One study in the elderly demonstrated associations between perisylvian cortex structure and measures of self transcendence [Kaasinen, V., Maguire, R.P., Kurki, T., Bruck, A., Rinne, J.O., 2005. Mapping brain structure and personality in late adulthood. NeuroImage 24, 315-322], but the neuroanatomical correlates of extraversion and neuroticism, or other measures of the Five Factor Model of personality have not been explored. The purpose of the present study was to investigate the structural correlates of neuroticism and extraversion in healthy elderly subjects (n=29) using neuroanatomic measures of the cerebral cortex and amygdala. We observed that the thickness of specific lateral prefrontal cortex (PFC) regions, but not amygdala volume, correlates with measures of extraversion and neuroticism. The results suggest differences in the regional neuroanatomic correlates of specific personality traits with aging. We speculate that this relates to the influences of age-related structural changes in the PFC.
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De Fruyt F, Van Leeuwen K, Bagby RM, Rolland JP, Rouillon F. Assessing and interpreting personality change and continuity in patients treated for major depression. Psychol Assess 2006; 18:71-80. [PMID: 16594814 DOI: 10.1037/1040-3590.18.1.71] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Structural, mean- and individual-level, differential, and ipsative personality continuity were examined in 599 patients treated for major depression assigned to 1 of 6 forms of a 6-month pharmaco-psychotherapy program. Covariation among traits from the Five Factor model remained invariant across treatment, and patients described themselves as slightly more extraverted, open to experience, agreeable and conscientious, and substantially more emotional stable after treatment. Trait changes were only to a small extent explained by changes in depression severity. There was evidence for differential, individual-level, and ipsative stability, with stable personality profiles in terms of shape and to a lesser extent in terms of scatter and elevation. Traits remain relatively stable, except for emotional stability, despite the depressive state and the psychopharmacological interventions.
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Affiliation(s)
- Filip De Fruyt
- Department of Psychology, Ghent University, Ghent, Belgium.
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The pathway from child personality to adult adjustment: The road is not straight. JOURNAL OF RESEARCH IN PERSONALITY 2005. [DOI: 10.1016/j.jrp.2004.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Abstract
The confusion of personality disorders with Axis I disorders can be traced in part to inadequacies of assessment instruments and diagnostic criterion sets. However, it also reflects the absence of adequate conceptualization. If Axis I continues to include early onset, chronic impairments that characterize everyday functioning, then there is unlikely to be a clear or meaningful distinction. Inherent and unique to personality disorders is that they concern a person's sense of self and identity. They are disorders of everyday functioning. Personality disorders have an early onset, characterize everyday functioning, and relate closely to personality functioning evident within the general population; Axis I disorders, in contrast, have an onset throughout adult life, are episodic, and are readily distinguishable from normal personality functioning.
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Affiliation(s)
- Thomas A Widiger
- Department of Psychology, University of Kentucky, Lexington, 40506-0044, USA.
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