Personality traits in social phobia

Affective Neuroscience Personality Scales and Early Maladaptive Schemas in Depressive Disorders

Aim: The aim of this study was to assess the interrelationships of Young’s early maladaptive schemas with indicators of specific neural emotional systems conceptualized in Panksepp’s theory in a group of people suffering from depressive disorders. Materials and methods: The Affective Neuroscience Personality Scales (ANPS) v. 2.4. and J. Young’s Early Maladaptive Schema Questionnaire (YSQ-S3-PL) were used. Ninety (90) individuals aged 18–58, including 45 people treated for depression (DD group), were qualified to participate in the experiment. Results: The subjects in the DD group scored statistically significantly lower than the subjects from the control group (CG group) on the three ANPS scale domains, namely SEEKING, PLAY, and ANGER. The subjects with depressive symptoms scored significantly higher in the YSQ-S3-PL questionnaire on two domains of early maladaptive schemas, i.e., “Impaired autonomy and performance” and “Other-directedness”. Regression analysis results indicate that impairment of the emotional SEEKING system explains most of the variability in the following typical domains of depression: “Disconnection and rejection”, “Impaired autonomy and performance”, and “Other-directedness”. For score variability in the domain area of “Impaired limits”, the ANGER system was found to be most significant, and the FEAR system proved the same for “Overvigilance and Inhibition”. Conclusions: 1. Two domains of early maladaptive schemas are significant for the onset of depressive symptoms, namely “Impaired autonomy and performance” and “Other-directedness”, linked to difficulties in engaging in behaviors to meet one’s own needs. 2. Impairment of the neural emotional SEEKING system most significantly explains the variability in depression-typical areas of early maladaptive schemas.

J. Young’s Early Maladaptive Schemas and Symptoms of Male Depression

Aim: There are more non-specific, hence harder to diagnose, symptoms in the picture of male depression. These symptoms are strongly linked to social norms and roles traditionally assigned to men. The aim of this study was to assess the interrelationship of early maladaptive schemas that affect the formation of self-image as a man with indicators of male depression. Materials and methods: The Gender-Sensitive Depression Screening (GSDS-26) by A.M. Möller-Leimkühler and the Early Maladaptive Schema Questionnaire by J. Young (YSQ-S3-PL) were used. A group of 75 men (aged 18 to 50) were qualified to take part in the research. Results: The total score of the GSDS-26 scale and individual indicators of male depression are strongly positively correlated with the severity of all five domains of the YSQ-S3-PL questionnaire. The highest correlation coefficient value was obtained in the following areas: “Disconnection and rejection” (0.741), “Other-directedness” (0.711), and “Overvigilance and inhibition” (0.711). In case of the GSDS-26 total score and the following indicators—Elevated stress, Aggressiveness, Emotional control, Risky behavior, and Classic symptoms of depression—positive statistically significant associations were confirmed with each of the 18 schemas from the YSQ-S3-PL questionnaire. Multiple regression results revealed that the following domains were significant for symptoms typical of male depression: “Disconnection and rejection” and “Impaired autonomy and performance”. The “Impaired limits” area was found to be statistically significant only for symptoms of classic depression. Conclusions: (1) The GSDS-26 scale scores show positive associations with each domain of the YSQ-S3-PL questionnaire. (2) The following areas seem to be more important for atypical depressive symptoms in men: “Disconnection and rejection” and “Impaired autonomy and performance”, while for classic depression: “Impaired limits” was more important. (3) In therapeutic work with male depressive symptoms, it is useful to focus on dominant maladaptive schemas alongside beliefs about stereotypical male roles.

Higher- and lower-order personality traits and cluster subtypes in social anxiety disorder

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.

The Differential Profile of Social Anxiety Disorder (SAD) and Avoidant Personality Disorder (APD) on the Basis of Criterion B of the DSM-5-AMPD in a College Sample

Background

The present study was conducted to determine the differential profile of social anxiety disorder (SAD) and avoidant personality disorder (APD) based on dimensional diagnosis in criterion B of the DSM-5 Alternative Model for Personality Disorders (DSM-5-AMPD) in a college sample.

Methods

Samples of this cross-sectional study included 320 (23.08 ± 2.66 years; 57% female) college students in western Iran during February 2015 to December 2017. Liebowitz-social anxiety scale, PID-5, SCID-II, SCID-II-SQ and diagnostic interview for SAD were the tools. The data were analysed using Pearson correlation and multiple linear regression analysis.

Results

Forty-three and 38 participants met criteria for SAD alone and APD, respectively. Five main domains of PID-5 could explain 29% and 54% of the variance of SAD and APD, respectively. Facets of negative affect, detachment, antagonism, disinhibition, and psychoticism could explain 25% versus 43%, 26% versus 54%, 7% versus 27%, 21% versus 41%, 13% versus 30% of the variance of SAD and APD, respectively.

Conclusion

SAD and APD probably refer to two distinct mental states having prominent anxiety, emotional instability, and interpersonal pattern of avoidance and detachment of challenge. SAD is a simple form of mental disturbances with anxiety in its core features; although, APD is possibly referring to more complicated psychopathology.

A personality and impairment approach to examine the similarities and differences between avoidant personality disorder and social anxiety disorder

The current study examined whether avoidant personality disorder (AvPD) and social anxiety disorder (SAD) should be considered distinct disorder constructs, which is a persistent and controversial issue in the clinical literature. We examined whether relative scores on SAD and AvPD were associated with the same personality profile and severity of impairment. The current research used a cross-sectional design and self-report inventories, including multiple measures of personality, impairment and psychopathology. Results from a mixed sample of 402 university and community participants found that scores on AvPD and SAD were similarly associated with personality traits and impairment indices. Moreover, a latent construct accounting for the shared variance for AvPD and SAD was associated with personality traits and impairment, whereas the residuals representing the uniquenesses of these disorder constructs were not. These findings support the view that AvPD and SAD are similar disorders from a phenotypic personality trait and impairment perspective. These findings are contrary to a prevalent view in the literature, known as severity continuum hypothesis, because the two disorders could not be meaningfully differentiated based on severity of impairment. Copyright © 2016 John Wiley & Sons, Ltd.

Comorbidity of personality disorders in anxiety disorders: a meta-analysis of 30 years of research

BACKGROUND

A comprehensive meta-analysis to identify the proportions of comorbid personality disorders (PD) across the major subtypes of anxiety disorders (AD) has not previously been published.

METHODS

A literature search identified 125 empirical papers from the period 1980-2010 on patients with panic disorders, social phobia, generalised anxiety, obsessive-compulsive (OCD) and post-traumatic stress disorder (PTSD). Several moderators were coded.

RESULTS

The rate of any comorbid PD was high across all ADs, ranging from .35 for PTSD to .52 for OCD. Cluster C PDs occurred more than twice as often as cluster A or B PDs. Within cluster C the avoidant PD occurred most frequently, followed by the obsessive-compulsive and the dependent PD. PTSD showed the most heterogeneous clinical picture and social phobia was highly comorbid with avoidant PD. A range of moderators were examined, but most were non-significant or of small effects, except an early age of onset, which in social phobia increased the risk of an avoidant PD considerably. Gender or duration of an AD was not related to variation in PD comorbidity.

LIMITATIONS

Blind rating of diagnoses was recorded from the papers as an indication of diagnostic validity. However, as too few studies reported it the validity of the comorbid estimates of PD was less strong.

CONCLUSIONS

The findings provided support to several of the proposed changes in the forthcoming DSM-5. Further comorbidity studies are needed in view of the substantial changes in how PDs will be diagnosed in the DSM-5.

Shame, personality, and social anxiety symptoms in Chinese and American nonclinical samples: a cross-cultural study

Shame has been observed to play an important role in social anxiety in China [Xu, 1982]. Shame and personality factors, such as neuroticism and introversion-extraversion, are also related to social anxiety symptoms in Chinese college students [Li et al., 2003]. The aim of this study was to explore cross-cultural differences of the effects of shame and personality on social anxiety using the Experience Scale of Shame, the Eysenck Personality Questionnaire-Revised Short Scale and Social Anxiety Inventory. Data were collected from both a Chinese sample (n=211, 66 males and 145 females, average ages 20.12+/-1.56 years) and an American sample (n=211, 66 males and 145 females, average ages 20.22+/-1.90 years) of college students. The structural equation modeling (SEM) was performed separately for the Chinese and American samples. The SEM results reveal a shame-mediating model, which is adaptive and only in the Chinese sample. This suggests that shame is a mediator between the Chinese personality and social anxiety. The shame factor did not play the same role in the American sample. This empirical study supports the hypothesis that shame has a more important effect on social anxiety in the Chinese culture compared to its effect on Americans.

Personality may influence reactivity to stress

BACKGROUND

Possible mechanisms behind psychophysiological hyperreactivity may be located at a cognitive-emotional level. Several personality traits have been associated with increased cardiovascular reactivity. Subjects with white coat hypertension, which may constitute a kind of hyperreactivity, are found to suppress their emotions and adapt to the surroundings to a larger extent than controls.We hypothesized in this study that a) stress reactivity is related to personality, and that b) responses to cold pressor test (CPT) and mental stress test (MST) are associated with different personality traits.

METHODS

87 men were selected from the 1st, 50th and 99th percentile of a blood pressure screening. Cardiovascular and catecholamine responses to MST and CPT were recorded. Fifteen personality traits were assessed using the Karolinska Scale of Personality. Possible independent explanatory predictors for cardiovascular and catecholamine variables at baseline and during stress were analyzed in multiple linear regression analyses using a stepwise forward procedure.

RESULTS

Multiple regression analyses showed that muscular tension (beta = 0.298, p = 0.004), irritability (beta = 0.282, p = 0.016), detachment (beta = 0.272, p = 0.017), psychasthenia (beta = 0.234, p = 0.031) and somatic anxiety (beta = 0.225, p = 0.046) were significant explanatory variables of reactivity to CPT. During MST, verbal aggression (beta = -0.252, 0.031) and detachment (beta = 0.253, p = 0.044) were significant predictors of norepinephrine and diastolic blood pressure response, respectively.Based on KSP-trait quartiles, delta (Delta) systolic (p = 0.025) and Delta diastolic blood pressure (p = 0.003) during MST were related to detachment score, with the highest reactivity in the 4th quartile, while Delta norepinephrine was significantly related to muscular tension (p = 0.033). Delta systolic and Delta diastolic blood pressure responses to CPT were dependent on detachment (p = 0.049 and p = 0.011, respectively) and psychasthenia (p = 0.020 and p = 0.015), while high verbal aggression was associated with lower reactivity measured by Delta norepinephrine (p = 0.037).

CONCLUSION

The present study indicates that stress reactivity is clearly related to different personality traits, without any single trait being dominant over others. Furthermore, personality seems to have as much, or even more, importance of predicting responses to CPT than responses to MST.

The role of life events in social phobia

The aim was to investigate the relationship between life events and social phobia. An inventory assessing life events during childhood, adulthood as well as life events experienced in relation to the onset of the disorder was administrated to 30 subjects with a DSM-IV diagnosis of social phobia. They were recruited by announcement and diagnosed by the Structured Clinical Interview for DSM-IV for axes I and II disorders. Seventy-five controls were selected by matching age and gender from the local population register. Individuals with social phobia reported significantly more life events during childhood and more life events with negative impact during the social phobia debuting year. Conversely, they described fewer events in the adult life than the controls. Close relatives with disabling conditions in the childhood, conflicts with wife/husband/cohabitant and divorces or similar were significantly more common in the debuting year in social phobic group. In adult life, the healthy individuals described significantly more often increased authority at work. A gender-specific analysis revealed significantly more experiences of a death of a relative/close friend during the year before the social phobia debut and significantly more negative life events in the women's adult life. In summary, the present results support that life events have a role in social phobia that may be gender influenced.

Global assessment of psychosocial functioning in child and adolescent psychiatry. A review of three unidimensional scales (CGAS, GAF, GAPD)

Global assessment of functioning represents an important aspect of assessment in clinical practice and research. It can help identify persons in need of psychiatric treatment, have predictive value and measure change over time, including treatment effects. This review examines publications concerning development, psychometric properties and usefulness of three scales for children: Axis-VI in ICD-10 Global Assessment of Psychosocial Disability (GAPD), Children's Global Assessment Scale (CGAS) and Axis-V in DSM-IV Global Assessment of Functioning Scale (GAF). It is based on literature searches in PubMed and PsycInfo (1977-2003), and screening of Scandinavian and English textbooks on child psychiatry. The three scales differ in theoretical guidelines, descriptions of codes/anchor points and psychometric aspects. CGAS has been evaluated in 69 papers and 33 have been published on GAF used for children. The one paper comparing GAPD and CGAS found both scales sufficiently reliable for clinical practice. Reliability of CGAS and GAF has been found to vary from fair to substantial, depending on raters, training and diagnostic groups. International consensus for the use of one scale for global assessment of functioning for children 4-18 years would improve reliability in clinical practice and ease comparisons of studies across countries. A training programme would assist in this.