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Köhler-Forsberg O, Keers R, Uher R, Hauser J, Maier W, Rietschel M, McGuffin P, Farmer AE, Aitchison KJ, Mors O. Dimensions of temperament and character as predictors of antidepressant discontinuation, response and adverse reactions during treatment with nortriptyline and escitalopram. Psychol Med 2023; 53:2522-2530. [PMID: 34763734 DOI: 10.1017/s003329172100444x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Personality traits may predict antidepressant discontinuation and response. However, previous studies were rather small, only explored a few personality traits and did not include adverse drug effects nor the interdependency between antidepressant discontinuation patterns and response. METHODS GENDEP included 589 patients with unipolar moderate-severe depression treated with escitalopram or nortriptyline for 12 weeks. Seven personality dimensions were measured using the self-reported 240-item Temperament and Character Inventory-Revised (TCI-R). We applied Cox proportional models to study discontinuation patterns, logistic and linear regression to investigate response and remission after 8 and 12 weeks, and mixed-effects linear models regarding time-varying treatment response and adverse drug reactions. RESULTS Low harm avoidance, low cooperativeness, high self-transcendence and high novelty seeking were associated with higher risks for antidepressant discontinuation, independent of depressed mood, adverse drug reactions, drug, sex and age. Regression analyses showed that higher novelty seeking and cooperativeness scores were associated with a greater likelihood of response and remission after 8 and 12 weeks, respectively, but we found no correlations with response in the mixed-effects models. Only high harm avoidance was associated with more self-reported adverse effects. CONCLUSIONS This study, representing the largest investigation between several personality traits and response to two different antidepressants, suggests that correlations between personality traits and antidepressant treatment response may be confounded by differential rates of discontinuation. Future trials on personality in the treatment of depression need to consider this interdependency and study whether interventions aiming at improving compliance for some personality types may improve response to antidepressants.
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Affiliation(s)
- Ole Köhler-Forsberg
- Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Robert Keers
- Department of Biological and Experimental Psychology, Queen Mary University of London, Mile End, London, UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rudolf Uher
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Joanna Hauser
- Department of Psychiatry, Laboratory of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Peter McGuffin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anne E Farmer
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Katherine J Aitchison
- Department of Psychiatry, Department of Medical Genetics, University of Alberta, Edmonton, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Mihailovic M, Garcia D, Amato C, Lindskär E, Rosenberg P, Björk E, Lester N, Cloninger KM, Cloninger C. The personality of newly graduated and employed nurses: Temperament and character profiles of Swedish nurses. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100058. [PMID: 38745598 PMCID: PMC11080479 DOI: 10.1016/j.ijnsa.2021.100058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/12/2021] [Accepted: 12/14/2021] [Indexed: 11/30/2022] Open
Abstract
Background One of the challenges of the 21st century is the high turnover rate in the nursing profession due to burnout and mental illness. From a biopsychosocial perspective, an individual's personality is an important vulnerability-resilience factor that comprises four temperament traits (i.e., a person's emotional reactions) and three character traits (i.e., self-regulation systems). Indeed, different personality profiles are associated to different coping strategies and health outcomes. Objective We investigated and mapped the temperament and character of Swedish newly graduated and employed nurses' in relation to the Swedish general population and an age-matched sub-sample. Design In this cross-sectional study, nurses self-reported their personality (Temperament and Character Inventory) at the beginning of their employment. Setting The data collection was conducted at a hospital in the South of Sweden. Participants A total of 118 newly graduated and employed nurses (Mage = 25.95±5.58) and 1,564 individuals from the Swedish general population participated in the study. Methods We calculated T-scores and percentiles for all seven personality dimensions using the Swedish norms (N = 1,564). The profiles were calculated by combining high/low percentiles scores in three temperament dimensions (Novelty Seeking: N/n, Harm Avoidance: H/h, and Reward Dependence: R/r) and in the three character dimensions (Self-Directedness: S/s, Cooperativeness: C/c and Self-Transcendence: T/t). Results Regarding T-scores, the nurses reported moderately lower Novelty Seeking (> 0.5 SD), slightly higher Harm-Avoidance (about 0.5 SD), moderately higher Persistence (> 0.5 SD) and Reward Dependence (> 0.5 SD), and extremely lower Self-Directedness (> 1 SD). The prevalence of the most common temperament profiles among the nurses (Swedish general population in brackets) were: 39.80% [10.90%] Cautious (nHR), 21.20% [10.90] Reliable (nhR), and 15.30% [16.50%] Methodical (nHr). The prevalence of the most common character profiles among the nurses were: 31.40% [4.90%] Dependent (sCt), 25.40% [14.40%] Apathetic (sct), and 19.50% [8.80%] Moody (sCT). Conclusions The analyses of the personality profiles showed that Low Novelty Seeking (79%), high Harm Avoidance (65%) high Reward Dependence (80%), low Self-Directedness (95%), and low Self-Transcendence (60%) were more prevalent among the newly graduated and employed nurses. This may partially explain newly graduated nurses' difficulties at work and high turnover rate. After all, a well-developed character is of special importance when working with patients with serious and terminal illness or under large global crises, such as the current pandemic. Hence, both education at universities and development at work need to be person-centered to reduce stress levels and promote positive self-regulation strategies.
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Affiliation(s)
- Marko Mihailovic
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA
- Promotion of Health and Innovation (PHI) Lab, International Network for Well-Being, USA
| | - Danilo Garcia
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
- Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden
- Promotion of Health and Innovation (PHI) Lab, International Network for Well-Being, Sweden
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
- Department of Psychology, Lund University, Lund, Sweden
| | - Clara Amato
- Promotion of Health and Innovation (PHI) Lab, International Network for Well-Being, Italy
| | - Erik Lindskär
- Promotion of Health and Innovation (PHI) Lab, International Network for Well-Being, Sweden
| | - Patricia Rosenberg
- Promotion of Health and Innovation (PHI) Lab, International Network for Well-Being, Sweden
| | - Elina Björk
- Promotion of Health and Innovation (PHI) Lab, International Network for Well-Being, Sweden
| | - Nigel Lester
- Promotion of Health and Innovation (PHI) Lab, International Network for Well-Being, USA
- Anthropedia Foundation, St. Louis, Missouri, USA
| | - Kevin M. Cloninger
- Promotion of Health and Innovation (PHI) Lab, International Network for Well-Being, USA
- Promotion of Health and Innovation (PHI) Lab, International Network for Well-Being, Italy
- Anthropedia Foundation, St. Louis, Missouri, USA
- College for Public Health and Justice, Saint Louis University, St. Louis, Missouri, USA
| | - C.Robert Cloninger
- Promotion of Health and Innovation (PHI) Lab, International Network for Well-Being, USA
- Anthropedia Foundation, St. Louis, Missouri, USA
- Center for Well-being, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
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Apud Peláez IE. Personality Traits in Former Spanish Substance Users Recovered with Ayahuasca. J Psychoactive Drugs 2020; 52:264-272. [PMID: 32362241 DOI: 10.1080/02791072.2020.1752960] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Ayahuasca is a psychoactive brew that contains N,N-dimethyltryptamine and monoamine oxidase-inhibiting alkaloids. It is originally from the Amazon rainforest, but since the 1990s it has expanded worldwide. The compound is used in different religious, spiritual, and therapeutic settings. One of its common applications is for the treatment of addiction. The current study is an assessment of the impact of ayahuasca on personality traits in former substance users from Catalonia and surrounding areas. When compared with a control group, the ayahuasca group had statistically significantly higher scores in the dimensions Novelty Seeking and Self-Transcendence, and in the traits Attachment, Impulsivity, Compassion, and Spiritual Acceptance. Results suggest that recovery could be related less to a reduction of Impulsivity and Novelty Seeking, main features of substance use disorder (SUD), and more to an increase of Character dimensions and traits, especially Self-Transcendence and Cooperativeness. Those changes could be triggered by self-reflective, prosocial, and transcendental ayahuasca ritual experiences, which in the qualitative part of the research were described by the participants as being of great importance for their recovery, helping with the reconstruction of personal goals, gratifications, social bonds, and the general life's projection.
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Affiliation(s)
- Ismael Eduardo Apud Peláez
- Faculty of Psychology (UdelaR, Montevideo, Uruguay), National System of Researchers (ANII, Montevideo, Uruguay), Medical Anthropology Research Center (URV, Tarragona, Spain)
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Chotai J, Jonasson M, Hägglöf B, Adolfsson R. Adolescent attachment styles and their relation to the temperament and character traits of personality in a general population. Eur Psychiatry 2020; 20:251-9. [PMID: 15935425 DOI: 10.1016/j.eurpsy.2004.11.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2004] [Accepted: 11/01/2004] [Indexed: 11/23/2022] Open
Abstract
AbstractAttachment styles as well as personality traits in adolescents and adults have been found to be associated with their health outcomes and with their personality pathology. In this cross-sectional exploratory study, we study the relationship between attachment styles that derive from our data employing the items of Feeney et al. (1994) self-report attachment style questionnaire (ASQ), and personality traits given by the junior version of Cloninger et al. (1993) self-report temperament and character inventory (TCI), in a sample of 426 adolescents (54% females) from a general population. The secure attachment style was correlated significantly negatively with the personality trait harm avoidance (HA), but significantly positively with the personality traits novelty seeking (NS), reward dependence (RD), cooperativeness (CO) and self-transcendence (ST). The preoccupied (anxious/ambivalent) attachment style was correlated significantly positively with HA and NS, but significantly negatively with self-directedness (SD). The fearful-avoidant category was correlated significantly negatively with NS. Our five-factor solution of the attachment styles and their relation to the TCI point towards a need for a modification of the two-axis, four-category attachment model of Bartholomew (1990) and Bartholomew and Horowitz (1991), with their category dismissing-avoidant replaced by the two categories defined here as dismissing relations (correlated significantly negatively with CO) and dismissing others (correlated significantly negatively with RD and significantly positively with SD).
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Affiliation(s)
- Jayanti Chotai
- Division of Psychiatry, Department of Clinical Sciences, University Hospital, University of Umeå, 901 85 Umeå, Sweden.
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Forcano L, Fernández-Aranda F, Álvarez-Moya E, Bulik C, Granero R, Gratacòs M, Jiménez-Murcia S, Krug I, Mercader JM, Riesco N, Saus E, Santamaría JJ, Estivill X. Suicide attempts in bulimia nervosa: Personality and psychopathological correlates. Eur Psychiatry 2020; 24:91-7. [DOI: 10.1016/j.eurpsy.2008.10.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2008] [Revised: 10/06/2008] [Accepted: 10/14/2008] [Indexed: 10/21/2022] Open
Abstract
AbstractBackgroundLittle evidence exists about suicidal acts in eating disorders and its relation with personality. We explored the prevalence of lifetime suicide attempts (SA) in women with bulimia nervosa (BN), and compared eating disorder symptoms, general psychopathology, impulsivity and personality between individuals who had and had not attempted suicide. We also determined the variables that better correlate with of SA.MethodFive hundred sixty-six BN outpatients (417 BN purging, 47 BN non-purging and 102 subthreshold BN) participated in the study.ResultsLifetime prevalence of suicide attempts was 26.9%. BN subtype was not associated with lifetime SA (p = 0.36). Suicide attempters exhibited higher rates on eating symptomatology, general psychopathology, impulsive behaviors, more frequent history of childhood obesity and parental alcohol abuse (p < 0.004). Suicide attempters exhibited higher scores on harm avoidance and lower on self-directedness, reward dependence and cooperativeness (p < 0.002). The most strongly correlated variables with SA were: lower education, minimum BMI, previous eating disorder treatment, low self-directedness, and familial history of alcohol abuse (p < 0.006).ConclusionOur results support the notion that internalizing personality traits combined with impulsivity may increase the probability of suicidal behaviors in these patients. Future research may increase our understanding of the role of suicidality to work towards rational prevention of suicidal attempts.
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Obsessive-compulsive personality disorder traits and personality dimensions in parents of children with obsessive-compulsive disorder. Eur Psychiatry 2020; 24:201-6. [DOI: 10.1016/j.eurpsy.2008.11.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Revised: 10/16/2008] [Accepted: 11/12/2008] [Indexed: 11/17/2022] Open
Abstract
AbstractPurposeTo compare patterns of temperament and character and the prevalence of Obsessive-Compulsive Personality Disorder (OCPD) and OCPD traits in parents of children with OCD and parents of healthy controls.MethodsTCI and SCID-II were administered to 63 parents of 32 children with OCD and 63 parents of age- and sex-matched controls with no psychiatric diagnosis. Interviewers were not blind to proband status. Personality dimension scores and frequencies of OCPD criteria in both groups were compared after excluding parents with a diagnosis of OCD. Relationships between TCI dimensions and OCPD symptoms in parents and the clinical characteristics of OCD children were also studied.ResultsParents of OCD children presented significantly higher scores in harm avoidance and lower scores in self-directedness, cooperativeness and reward dependence than parents of healthy children. A higher incidence of OCPD was found in parents of probands (p < 0.02). Hoarding, perfectionism and preoccupation with details were significantly more frequent in parents of OCD children. Counting, ordering and cleaning compulsions in OCD children predicted elevated odds of perfectionism and rigidity in their parents.ConclusionsThe existence of the dimensional personality profile associated with OCD in parents of children with OCD and the higher number of OCPD criteria in these parents in comparison to parents of healthy children highlight the importance of the role of personality factors in familial OCD.
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Temperament profiles, major depression, and response to treatment with SSRIs in psychiatric outpatients. Eur Psychiatry 2020; 27:245-9. [DOI: 10.1016/j.eurpsy.2010.07.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 07/14/2010] [Accepted: 07/14/2010] [Indexed: 01/22/2023] Open
Abstract
AbstractObjectiveThe Temperament and Character Inventory (TCI) is commonly used in adult populations. Our aim was to explore: (1) if there are specific differences in temperament dimensions related to depression in comparison with general population, (2) if the treatment response during the acute phase of major depressive disorder (MDD) is predictable by TCI temperament dimensions.MethodTemperament profiles in 98 MDD patients were compared with a Finnish community sample. The patients were treated with serotonin selective reuptake inhibitors (SSRIs) for 6weeks and their temperament profiles were assessed at baseline and endpoint. The harm avoidance (HA) and depression scores at baseline and endpoint were modelled with path analysis. For path modelling, we tested the relationships between different temperament dimensions and depression symptoms and other clinical variables with Mancova model.ResultsThe HA scores were significantly higher in patients both at baseline and endpoint compared to the Northern Finland 1966 Birth Cohort (NFBC). The patients, and especially males, had slightly higher reward dependency (RD) scores. HA at endpoint explained moderately the Montgomery Åsberg Depression Rating Scale (MADRS) endpoint score. HA endpoint score was strongly explained by HA baseline score.ConclusionsHA is associated with risk of and treatment response to depression.
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Characteristics of patients in an eating disorder sample who dropped out: 2-year follow-up. Eat Weight Disord 2019; 24:767-775. [PMID: 28717972 DOI: 10.1007/s40519-017-0416-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 07/04/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE This manuscript explores the characteristics of individuals diagnosed with an eating disorder who dropped out of treatment, compared with those who completed it. METHOD The participants were 196 patients diagnosed with eating disorders (according to DSM-IV-TR criteria) who consecutively began treatment for the first time in an eating disorders unit. They were assessed at baseline with a set of questionnaires evaluating eating habits, temperament, and general psychopathology. During the follow-up period, patients who dropped out were re-assessed via a telephone interview. RESULTS In the course of a 2-year follow-up, a total of 80 (40.8%) patients were labeled as dropouts, and 116 (59.2%) remaining subjects were considered completers. High TCI scores in the character dimensions of Disorderliness (NS4) (p < .01) and total Novelty Seeking (NST), along with low scores in Dependency (RD4), were significantly associated with dropout in the course of 2 years. Once the results were submitted to logistic regression analysis, dropout only remained associated with high scores in Disorderliness (NS4) and, inversely, with an initial Anorexia Nervosa (AN) diagnosis (p < .05). Reasons for dropout stated by the patients included logistic difficulties, subjective improvement of their condition, and lack of motivation. DISCUSSION Clinicians should handle the first therapeutic intervention with particular care in order to enhance their understanding of clients and their ability to rapidly identify those who are at risk of dropping out of treatment. LEVEL OF EVIDENCE Level III: Cohort Study.
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Calvo N, Sáez-Francàs N, Valero S, Castro-Marrero J, Alegre Martín J, Casas M. Diagnostic Concordance Between Categorical and Dimensional Instruments to Assess Personality Disorder in Chronic Fatigue Syndrome. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2017. [DOI: 10.1027/1015-5759/a000281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The study examines the relationship between a categorical and a dimensional personality assessment instrument in patients with Chronic Fatigue Syndrome (CFS). A total of 162 CFS patients were included in the study (91.4% women; mean age 47.5 years). All subjects completed the Spanish versions of the Personality Diagnostic Questionnaire-4+ (PDQ-4+) and the Temperament and Character Inventory-Revised (TCI-R). Results: 78 (48.1%) of the patients presented a Personality Disorder (PD), the most frequent being Cluster C, specifically Obsessive-compulsive disorder, followed by Avoidant disorder. PDs showed a specific pattern of correlation with temperament scales. All PD clusters correlated positively with Harm Avoidance and Self-Transcendence, and negatively with Reward Dependence, Self-Directedness, and Cooperativeness. In a logistic regression analysis, Self-Directedness and Cooperativeness predicted PD presence. The findings are consistent with previous studies in non-CFS samples and suggest that the combination of the Temperament and Character dimensions (low Self-Directedness and Cooperativeness and high Harm Avoidance and Self-Transcendence) correlates with PD severity, and that Self-Directedness and Cooperativeness are associated with PD presence in CFS patients. The integration of these two perspectives expands the current comprehension of personality pathology in CFS patients.
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Affiliation(s)
- Natalia Calvo
- Psychiatry Department, Hospital Universitari Vall d’Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Spain
- Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona, Spain
| | - Naia Sáez-Francàs
- Psychiatry Department, Hospital Universitari Vall d’Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Spain
| | - Sergi Valero
- Psychiatry Department, Hospital Universitari Vall d’Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Spain
- Institut Recerca Hospital Universitari Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona, Spain
| | - Jesús Castro-Marrero
- Chronic Fatigue Syndrome Research Unit, Institut de Recerca Hospital Universitari Vall d’Hebron (VHIR), Universitat Autònoma de Barcelona, Spain
| | - José Alegre Martín
- Psychiatry Department, Hospital Sant Rafael, FIDMAG. Hospital Universitari Vall d'Hebron, CIBERSAM, Departament of Psychiatry, Uniercitat Autònoma Barcelona
- Department of Internal Medicine, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel Casas
- Psychiatry Department, Hospital Universitari Vall d’Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Spain
- Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona, Spain
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Sauvaget A, Jiménez-Murcia S, Fernández-Aranda F, Granero R, Grall-Bronnec M, Victorri-Vigneau C, Bulteau S, Derkinderen P, Vanelle JM, Hakansson A, Mestre-Bach G, Steward T, Menchón JM. A Comparison of Treatment-Seeking Behavioral Addiction Patients with and without Parkinson's Disease. Front Psychiatry 2017; 8:214. [PMID: 29163234 PMCID: PMC5675875 DOI: 10.3389/fpsyt.2017.00214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 10/11/2017] [Indexed: 11/29/2022] Open
Abstract
The administration of dopaminergic medication to treat the symptoms of Parkinson's disease (PD) is associated with addictive behaviors and impulse control disorders. Little is known, however, on how PD patients differ from other patients seeking treatments for behavioral addictions. The aim of this study was to compare the characteristics of behavioral addiction patients with and without PD. N = 2,460 treatment-seeking men diagnosed with a behavioral addiction were recruited from a university hospital. Sociodemographic, impulsivity [Barratt Impulsiveness Scale (BIS-11)], and personality [Temperament and Character Inventory-Revised (TCI-R)] measures were taken upon admission to outpatient treatment. Patients in the PD group were older and had a higher prevalence of mood disorders than patients without PD. In terms of personality characteristics and impulsivity traits, PD patients appeared to present a more functional profile than PD-free patients with a behavioral addiction. Our results suggest that PD patients with a behavioral addiction could be more difficult to detect than their PD-free counterparts in behavioral addiction clinical setting due to their reduced levels of impulsivity and more standard personality traits. As a whole, this suggests that PD patients with a behavioral addiction may have different needs from PD-free behavioral addiction patients and that they could potentially benefit from targeted interventions.
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Affiliation(s)
- Anne Sauvaget
- Department of Psychiatry, Institut d'Investigació Biomédica de Bellvitge (IDIBELL), Bellvitge University Hospital, Barcelona, Spain.,Addictology and Liaison Psychiatry Department, Nantes University Hospital, Nantes, France
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Institut d'Investigació Biomédica de Bellvitge (IDIBELL), Bellvitge University Hospital, Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Institut d'Investigació Biomédica de Bellvitge (IDIBELL), Bellvitge University Hospital, Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marie Grall-Bronnec
- Addictology and Liaison Psychiatry Department, Nantes University Hospital, Nantes, France.,INSERM, SPHERE U1246, University of Nantes, Nantes, France.,INSERM, SPHERE U1246, University of Tours, Nantes, France
| | - Caroline Victorri-Vigneau
- INSERM, SPHERE U1246, University of Nantes, Nantes, France.,INSERM, SPHERE U1246, University of Tours, Nantes, France.,Clinical Pharmacology Department, Centre for Evaluation and Information on Pharmacodependence, Nantes University Hospital, Nantes, France
| | - Samuel Bulteau
- INSERM, SPHERE U1246, University of Nantes, Nantes, France.,INSERM, SPHERE U1246, University of Tours, Nantes, France
| | - Pascal Derkinderen
- INSERM, U913, Nantes, France.,Department of Neurology, CHU Nantes, Nantes, France
| | - Jean M Vanelle
- Addictology and Liaison Psychiatry Department, Nantes University Hospital, Nantes, France
| | - Anders Hakansson
- Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden
| | - Gemma Mestre-Bach
- Department of Psychiatry, Institut d'Investigació Biomédica de Bellvitge (IDIBELL), Bellvitge University Hospital, Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Trevor Steward
- Department of Psychiatry, Institut d'Investigació Biomédica de Bellvitge (IDIBELL), Bellvitge University Hospital, Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - José M Menchón
- Department of Psychiatry, Institut d'Investigació Biomédica de Bellvitge (IDIBELL), Bellvitge University Hospital, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.,CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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Normative data and effects of age and gender on temperament and character dimensions across the lifespan in an Italian population: A cross-sectional validation study. J Affect Disord 2016; 204:83-91. [PMID: 27341424 DOI: 10.1016/j.jad.2016.06.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Revised: 05/09/2016] [Accepted: 06/05/2016] [Indexed: 01/18/2023]
Abstract
BACKGROUND The short version of the Temperament and Character Inventory (TCI-125) has been employed for the study of personality traits in both clinical and normal populations. However, to the best of our knowledge, no studies explored the psychometric properties of this instrument in healthy individuals across the lifespan. We here provide the Italian normative data and present the personality features according to age and gender in a sample of healthy individuals. METHODS A cross-sectional study was carried out in a total of 1430 Italian healthy individuals ranging from 13 to 67 years (59.3% females). We evaluated the factorial model of the TCI-125, explored the internal consistency of the scales and carried out univariate analyses of variance for the investigation of age and gender differences in temperament and character dimensions. RESULTS Confirmatory factor analysis only partially confirmed the factor structure, with some Reward Dependence, Self-Directedness, and Cooperativeness items showing poor fit. Overall we found acceptable internal consistencies for all the dimensions of the TCI-125 across all age groups, except for Reward Dependence, Persistence, and Novelty Seeking, which showed unsatisfactory internal consistency in younger age groups. Furthermore, we found significant age differences in most temperament and all character dimensions. Finally, in specific age groups we also observed significantly lower scores in males compared to females in Harm Avoidance, Reward Dependence and all character dimensions except for Self-Directedness, on which males scored higher than females. CONCLUSIONS Although this study only partially confirmed the factor structure of the TCI-125 and suggested limited homogeneity for some temperament scales, overall our results supported the reliability of the TCI-125, which can therefore be considered a useful tool for exploring personality traits in both clinical and normal samples. Moreover, this study suggested the need of using this instrument with caution in adolescents.
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Granero R, Fernández-Aranda F, Aymamí N, Gómez-Peña M, Fagundo AB, Sauchelli S, Del Pino-Gutiérrez A, Moragas L, Savvidou LG, Islam MA, Tàrrega S, Menchón JM, Jiménez-Murcia S. Subtypes of Pathological Gambling with Concurrent Illegal Behaviors. J Gambl Stud 2016; 31:1161-78. [PMID: 25228407 DOI: 10.1007/s10899-014-9499-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aims of this study are: to explore empirical clusters in a sample of individuals with a gambling disorder (GD) according to the presence of illegal behaviors, to describe the subgroups at a clinical level and to examine whether a temporal change has taken place across the last 9 years. The sample consisted of 378 patients with a GD who consecutively received outpatient treatment, and who reported the presence of the DSM-IV criteria "presence of illegal behavior". Two-step clustering procedure revealed the existence of four empirical groups, which differed in both sociodemographic and clinical profiles. The patients, who have committed illegal acts due to their gambling behavior, are a heterogeneous group in which it is possible to identify different subtypes, based on sociodemographic, psychopathological, clinical and personality characteristics.
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Affiliation(s)
- Roser Granero
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain. .,CIBER Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.
| | - Fernando Fernández-Aranda
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain. .,Pathological Gambling Unit, Department of Psychiatry, IDIBELL, University Hospital of Bellvitge, Feixa Llarga, s/n. 08907-L'Hospitalet de Llobregat, Barcelona, Spain. .,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.
| | - Neus Aymamí
- Pathological Gambling Unit, Department of Psychiatry, IDIBELL, University Hospital of Bellvitge, Feixa Llarga, s/n. 08907-L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Mónica Gómez-Peña
- Pathological Gambling Unit, Department of Psychiatry, IDIBELL, University Hospital of Bellvitge, Feixa Llarga, s/n. 08907-L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Ana Beatriz Fagundo
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain. .,Pathological Gambling Unit, Department of Psychiatry, IDIBELL, University Hospital of Bellvitge, Feixa Llarga, s/n. 08907-L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Sarah Sauchelli
- Pathological Gambling Unit, Department of Psychiatry, IDIBELL, University Hospital of Bellvitge, Feixa Llarga, s/n. 08907-L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Amparo Del Pino-Gutiérrez
- Pathological Gambling Unit, Department of Psychiatry, IDIBELL, University Hospital of Bellvitge, Feixa Llarga, s/n. 08907-L'Hospitalet de Llobregat, Barcelona, Spain. .,Department of Public Health, Mental Health and Mother-Infant Nursing, University School of Nursing, University of Barcelona, Barcelona, Spain.
| | - Laura Moragas
- Pathological Gambling Unit, Department of Psychiatry, IDIBELL, University Hospital of Bellvitge, Feixa Llarga, s/n. 08907-L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Lamprini G Savvidou
- Pathological Gambling Unit, Department of Psychiatry, IDIBELL, University Hospital of Bellvitge, Feixa Llarga, s/n. 08907-L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Mohammed A Islam
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain. .,Pathological Gambling Unit, Department of Psychiatry, IDIBELL, University Hospital of Bellvitge, Feixa Llarga, s/n. 08907-L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Salomé Tàrrega
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - José M Menchón
- Pathological Gambling Unit, Department of Psychiatry, IDIBELL, University Hospital of Bellvitge, Feixa Llarga, s/n. 08907-L'Hospitalet de Llobregat, Barcelona, Spain. .,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain. .,CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain.
| | - Susana Jiménez-Murcia
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain. .,Pathological Gambling Unit, Department of Psychiatry, IDIBELL, University Hospital of Bellvitge, Feixa Llarga, s/n. 08907-L'Hospitalet de Llobregat, Barcelona, Spain. .,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.
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Vitali M, Napolitano C, Berman MO, Minuto SF, Battagliese G, Attilia ML, Braverman ER, Romeo M, Blum K, Ceccanti M. Neurophysiological Measures and Alcohol Use Disorder (AUD): Hypothesizing Links between Clinical Severity Index and Molecular Neurobiological Patterns. ACTA ACUST UNITED AC 2016; 5. [PMID: 28090374 PMCID: PMC5231399 DOI: 10.4172/2155-6105.1000181] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background In 1987, Cloninger proposed a clinical description and classification of different personality traits genetically defined and independent from each other. Moreover, he elaborated a specific test the TCI to investigate these traits/states. The study of craving in Alcohol Use Disorder (AUD) assumed a greater significance, since ever more data seems to suggest a direct correlation between high levels of craving and a higher risk of relapse in alcoholics. Thus, our study aim is to explore the possible correlations among TCI linked molecular neurobiological pattern (s), craving and alcohol addiction severity measures in a sample of Italian alcoholics. Materials and Methods 191 alcoholics were recruited in a Day Hospital (DH) setting at the Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome. After 7 days detoxification treatment a psychodiagnostic protocol was administered, including TCI, VAS-C, ASI and SADQ. All patients signed an Institutional Review Board (IRB) approved informed consent. Results Principally, we detected a significant positive correlation between HA-scale scores and the VAS scale: increasing in HA-scale corresponds to an increase in craving perception for both intensity (r=0.310; p ≤ 0.001) and frequency (r=0.246; p ≤ 0.001). Moreover, perception of dependence severity, measured with SADQ was also found to be significantly associated positively to both HA-scale (r=0.246; p ≤ 0.001) and NS-scale (r=0.224; p ≤ 0.01). While, for character scales, Persistence (r=−0.195; p=.008) and Self-directedness (r=−0.294; p ≤ 0.001) was negatively associated with ASI linked to alcohol problems. Self-directedness was also negatively correlated with ASI linked to family and social problems (r=−0.349; p ≤ 0.001), employment and support problems (r=−0.220; p=0.003) and psychiatric problems (r=−0.358; p ≤ 0.001). Cooperativeness was a negative correlate with Legal Problems (r=−0.173; p=0.019). and Self-Transcendence was positive correlated with Medical Problems (r=0.276; p ≤ 0.001) Conclusions In view of recent addiction neurobiological theories, such as the “Reward Deficiency Syndrome (RDS)” and the Koob model, our data could suggest that our cohort of patients could possibly be in a particular stage of the course of their addiction history. Thus, if our hypothesis will be confirmed, the TCI-based assessment of alcoholics would allow an optimization of the treatment. Clinicians understanding these newer concepts will be able to translate this information to their patients and potentially enhance clinical outcome (s), because it could suggest a functional hypothesis of neurotransmitter circuits that helps to frame the patient in his/her history of addiction.
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Affiliation(s)
- Mario Vitali
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Carmen Napolitano
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Marlene Oscar Berman
- Department of Psychiatry and Neurology, Boston University School of Medicine and Veterans Administration System, Boston, Massachusetts, USA
| | | | - Gemma Battagliese
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Maria Luisa Attilia
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Eric R Braverman
- Department of Psychiatry & McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, USA; Department of Clinical Neurology, Path Foundation, NY, New York, New York, USA
| | - Marina Romeo
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, USA; Department of Clinical Neurology, Path Foundation, NY, New York, New York, USA; Department of Addiction Research & Therapy, Malibu Beach Recovery Center, Malibu Beach, California, USA; Department of Psychiatry & Human Integrated Services Unit University of Vermont Center for Clinical & Translational Science, College of Medicine, Burlington, Vermont, USA; Department of Nutrigenomics, RD Solutions, LLC, La Jolla, California, USA; Department of Personalized Medicine, IGENE, LLC, Austin, Texas, USA; Dominion Diagnostics, LLC, North Kingstown, Rhode Island, USA; Basic & Clinical Research Center, Victory Nutrition, LLC., Austin, Texas, USA
| | - Mauro Ceccanti
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
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Giner-Bartolomé C, Steward T, Wolz I, Jiménez-Murcia S, Granero R, Tárrega S, Fernández-Formoso JA, Soriano-Mas C, Menchón JM, Fernández-Aranda F. The Influence of Personality Traits on Emotion Expression in Bulimic Spectrum Disorders: A Pilot Study. EUROPEAN EATING DISORDERS REVIEW 2016; 24:320-8. [DOI: 10.1002/erv.2446] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 02/25/2016] [Accepted: 02/26/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Cristina Giner-Bartolomé
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn); Instituto de Salud Carlos III, Barcelona; Spain
| | - Trevor Steward
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn); Instituto de Salud Carlos III, Barcelona; Spain
| | - Ines Wolz
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn); Instituto de Salud Carlos III, Barcelona; Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn); Instituto de Salud Carlos III, Barcelona; Spain
- Clinical Sciences Department; School of Medicine, University of Barcelona; Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn); Instituto de Salud Carlos III, Barcelona; Spain
- Department of Psychobiology and Methodology; Universitat Autònoma de Barcelona; Barcelona Spain
| | - Salomé Tárrega
- Department of Psychobiology and Methodology; Universitat Autònoma de Barcelona; Barcelona Spain
| | | | - Carles Soriano-Mas
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- Department of Psychobiology and Methodology; Universitat Autònoma de Barcelona; Barcelona Spain
- CIBER Salud Mental (CIBERSAM); Instituto de Salud Carlos III; Barcelona Spain
| | - José M. Menchón
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- Clinical Sciences Department; School of Medicine, University of Barcelona; Spain
- CIBER Salud Mental (CIBERSAM); Instituto de Salud Carlos III; Barcelona Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn); Instituto de Salud Carlos III, Barcelona; Spain
- Clinical Sciences Department; School of Medicine, University of Barcelona; Spain
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Fahlgren E, Nima AA, Archer T, Garcia D. Person-centered osteopathic practice: patients' personality (body, mind, and soul) and health (ill-being and well-being). PeerJ 2015; 3:e1349. [PMID: 26528411 PMCID: PMC4627917 DOI: 10.7717/peerj.1349] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/05/2015] [Indexed: 12/30/2022] Open
Abstract
Background. Osteopathic philosophy and practice are congruent with the biopsychosocial model, a patient-centered approach when treating disease, and the view of the person as a unity (i.e., body, mind, and soul). Nevertheless, a unity of being should involve a systematic person-centered understanding of the patient's personality as a biopsychosociospiritual construct that influences health (i.e., well-being and ill-being). We suggest Cloninger's personality model, comprising temperament (i.e., body) and character (i.e., mind and soul), as a genuine paradigm for implementation in osteopathic practice. As a first step, we investigated (1) the relationships between personality and health among osteopathic patients, (2) differences in personality between patients and a control group, and (3) differences in health within patients depending on the presenting problem and gender. Method. 524 osteopathic patients in Sweden (age mean = 46.17, SD = 12.54, 388 females and 136 males) responded to an online survey comprising the Temperament and Character Inventory and measures of health (well-being: life satisfaction, positive affect, harmony in life, energy, and resilience; ill-being: negative affect, anxiety, depression, stress, and dysfunction and suffering associated to the presenting problem). We conducted two structural equation models to investigate the association personality-health; graphically compared the patients' personality T-scores to those of the control group and compared the mean raw scores using t-tests; and conducted two multivariate analyses of variance, using age as covariate, to compare patients' health in relation to their presenting problem and gender. Results. The patients' personality explained the variance of all of the well-being (R (2) between .19 and .54) and four of the ill-being (R (2) between .05 and .43) measures. Importantly, self-transcendence, the spiritual aspect of personality, was associated to high levels of positive emotions and resilience. Osteopathic patients, compared to controls, scored higher in six of the seven personality dimensions. These differences were, however, not considerably large (divergences in T-scores were <1 SD, Cohen's d between 0.12 and 0.40). Presenting problem and gender did not have an effect on any of the health measures. Conclusion. The patient's personality as a ternary construct (i.e., body, mind, and soul), which is in line with osteopathy, is associated to both well-being and ill-being. The lack of substantial differences in personality between patients and controls implies that the patients had not any personality disorders. Hence, osteopaths might, with proper education, be able to coach their patients to self-awareness. The lack of differences in health variables between osteopathic patients with different presenting problems suggests that practitioners should focus on the person's health regardless of the type of presenting problem.
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Affiliation(s)
- Elin Fahlgren
- Network for Empowerment and Well-Being, Gothenburg, Sweden
- Dresden International University, Dresden, Germany
- Osteopathie Schule Deutschland, Hamburg, Germany
| | - Ali A. Nima
- Network for Empowerment and Well-Being, Gothenburg, Sweden
| | - Trevor Archer
- Network for Empowerment and Well-Being, Gothenburg, Sweden
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Danilo Garcia
- Network for Empowerment and Well-Being, Gothenburg, Sweden
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
- Blekinge Center of Competence, Blekinge County Council, Karlskrona, Sweden
- Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden
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Giner-Bartolomé C, Fagundo AB, Sánchez I, Jiménez-Murcia S, Santamaría JJ, Ladouceur R, Menchón JM, Fernández-Aranda F. Can an intervention based on a serious videogame prior to cognitive behavioral therapy be helpful in bulimia nervosa? A clinical case study. Front Psychol 2015; 6:982. [PMID: 26236261 PMCID: PMC4500862 DOI: 10.3389/fpsyg.2015.00982] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 06/29/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Several studies have highlighted the implications of impulsivity and novelty seeking for both the maintenance and the process of recovery from bulimia nervosa (BN). Cognitive behavioral therapy (CBT) is the treatment of choice for BN, but for some cases, this treatment alone might not be sufficient for reducing the high levels of impulsivity. The paper presents a case report of a patient with BN, examining the effectiveness of using a videogame (VG; Playmancer) as an additional intervention designed to address impulsivity. DESIGN Psychometric and neuropsychological measures were collected at baseline. After this assessment, Playmancer was applied prior to CBT, following an "A-B-A-C-A" single case experimental design. Impulsivity levels were assessed with the Conner's Continuous Performance Test II (CPT-II). After the Playmancer treatment, the patient started CBT, and the levels of impulsivity were recorded again. Finally, psychometric and neuropsychological measures were collected after treatment. Weekly frequency of binges and vomiting were also recorded during the entire procedure. RESULTS After the VG intervention, psychometric measures such as anxiety levels, impulsivity and novelty seeking decreased. Regarding the neuropsychological measures, impulsivity levels (measured with the CPT-II) progressively decreased throughout the intervention, and an improvement in decision making capacities was observed. Furthermore, the frequency of binges also decreased during and after the VG intervention. DISCUSSION This case report suggests that using the Playmancer VG to reduce impulsivity prior to CBT may enhance the final results of the treatment for BN.
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Affiliation(s)
- Cristina Giner-Bartolomé
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain ; Ciber Fisiopatologia Obesidad y Nutrición, Instituto de Salud Carlos III , Barcelona, Spain
| | - Ana B Fagundo
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain ; Ciber Fisiopatologia Obesidad y Nutrición, Instituto de Salud Carlos III , Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain ; Ciber Fisiopatologia Obesidad y Nutrición, Instituto de Salud Carlos III , Barcelona, Spain ; Clinical Sciences Department, School of Medicine, University of Barcelona , Barcelona, Spain
| | - Juan J Santamaría
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain ; Ciber Fisiopatologia Obesidad y Nutrición, Instituto de Salud Carlos III , Barcelona, Spain
| | | | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain ; Clinical Sciences Department, School of Medicine, University of Barcelona , Barcelona, Spain ; Ciber Salud Mental, Instituto de Salud Carlos III , Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain ; Ciber Fisiopatologia Obesidad y Nutrición, Instituto de Salud Carlos III , Barcelona, Spain ; Clinical Sciences Department, School of Medicine, University of Barcelona , Barcelona, Spain
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Gárriz M, Gutiérrez F, Peri JM, Baillés E, Torrubia R. Coping strategies within a personality space. PERSONALITY AND INDIVIDUAL DIFFERENCES 2015. [DOI: 10.1016/j.paid.2015.02.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Vespa A, Ottaviani M, Fossati A, Giulietti MV, Spatuzzi R, Meloni C, Fabbietti P, Spazzafumo L, Rozsa S, Cloninger RC. Validation of the Italian translation of the Revised Temperament and Character Inventory--TCI-140--in adult participants and in participants with medical diseases. Compr Psychiatry 2015; 59:129-34. [PMID: 25726259 DOI: 10.1016/j.comppsych.2014.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 12/16/2014] [Accepted: 12/23/2014] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION This study aimed at assessing the reliability and construct validity of the TCI-140. SAMPLE 428 Italian participants. EXCLUSION CRITERIA psychiatric disorders. 100 subjects - longitudinal retest study. RESULTS The results of descriptive statistics of internal consistency reliabilities (Cronbach coefficient) of TCI-R dimensions showed: a strong internal consistence of the scales: HA (α = 0.84); RD (α = 0.70); SD (α = 0.86); C (α = 0.75); ST (α = 0.83); a low level in NS (α = 0.60). In relation to facets, internal consistency reliabilities (Cronbach coefficient) ranged from 0.14 C3 to 0.79 C4 (from 3rd to 4th facet of C scale). Correlations: highest inverse correlation between HA and SD (r = -0.56); moderate inverse correlations for: HA and PS (r = -0.37); C and RD(r = 0.32); C and SD (r = 0.44). P, SD, C and ST showed good inter class correlations (ICC) ≥ 70 maintaining a good stability of the measures over the time. Four factors accounted for 56.3% of the variance for temperament subscale. Subscales of: PS4, PS3 PS2, PS1, NS3 for factor 1; HA2, HA1, HA4, HA3 for factor 2; RD1, RD2 and RD3 for factor 3; NS4, NS1 and NS2 for factor 4. Three factors that were identified accounted for 58.3% of the variance for character subscales of: SD3, SD5, SD1, SD2 for factor 1; C4, C1, C5, SD4, C3 for factor 2; ST2, ST1, ST3, C2 for factor 3. CONCLUSION The reliability coefficients were significantly good for some dimensions of TCI-140 and showed a good correlation after time, while some dimensions as NS have low reliability. In the principal components analysis does not saturate all dimensions in its theoretical factor. Moreover TCI-140 is a useful inventory for the evaluation of the principal dimensions of temperament and character.
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Affiliation(s)
- Anna Vespa
- Scientific and Technological Area, Department of Neurology, INRCA-IRCCS National Institute of Health and Science on Aging, Ancona, Italy.
| | - Marica Ottaviani
- Department of Neurology, INRCA-IRCCS National Institute of Health and Science on Aging, via Della Montagnola n. 108, Ancona, Italy.
| | - Andrea Fossati
- Dipartimento Scienze Umane (Comunicazione, Formazione, Psicologia), Università Vita e Salute S. Raffaele, Milan, Italy.
| | - Maria Velia Giulietti
- Unity of Neurology, INRCA-National Institute of Health and Science on Aging, via Della Montagnola n. 108, Ancona, Italy.
| | - Roberta Spatuzzi
- U.O.C. Hospice/Palliative Care Departments, A.O.R. San Carlo di Potenza, Italy.
| | - Cristina Meloni
- Department of Research, Mineral Test Sas, Via A. Cecchetti, 7, Civitanova Marche, Macerata, Italy.
| | - Paolo Fabbietti
- Biostatistical Center, INRCA-IRCCS, National Institute of Health and Science on Aging, via S. Margherita n. 5, Ancona, Italy.
| | - Liana Spazzafumo
- Biostatistical Center, INRCA-IRCCS, National Institute of Health and Science on Aging, via S. Margherita n. 5, Ancona, Italy.
| | - Sandor Rozsa
- Department of Personality and Health Psychology, Loránd Eötvös University, Budapest, Hungary.
| | - Robert C Cloninger
- Center for Psychobiology of Personality, Sansone Center for Well-Being, Washington University St. Louis, St. Louis, MO, USA.
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Aragay N, Jiménez-Murcia S, Granero R, Fernández-Aranda F, Ramos-Grille I, Cardona S, Garrido G, Anisul Islam M, Menchón JM, Vallès V. Pathological gambling: understanding relapses and dropouts. Compr Psychiatry 2015; 57:58-64. [PMID: 25434846 DOI: 10.1016/j.comppsych.2014.10.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 10/10/2014] [Accepted: 10/13/2014] [Indexed: 10/24/2022] Open
Abstract
There is little available information on the factors that influence relapses and dropouts during therapy for pathological gambling (PG). The aim of this study was to determine socio-demographic, clinical, personality, and psychopathological predictors of relapse and dropout in a sample of pathological gamblers seeking treatment. A total of 566 consecutive outpatients diagnosed with PG according to DSM-IV-TR criteria were included. All patients underwent an individualized cognitive-behavioral treatment program. We analyzed predictors of relapse during 6months of treatment and during the subsequent 6months of follow-up, and predictors of dropout over the entire therapeutic program. Eighty patients (14.1%) experienced at least one relapse during the entire follow-up of the study: 50 (8.8%) within the treatment period and 12 (2.1%) during the subsequent 6-month follow-up period. The main predictors of relapse were single marital status, spending less than 100euros/week on gambling, active gambling behavior at treatment inclusion, and high scores on the TCI-R Harm Avoidance personality dimension. One hundred fifty-seven patients (27.8%) missed 3 or more therapeutic sessions over the entire therapeutic program. The main predictors of dropout were single marital status, younger age, and high scores on the TCI-R Novelty Seeking personality dimension. The presence of these factors at inclusion should be taken into account by physicians dealing with PG patients.
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Affiliation(s)
- Núria Aragay
- Pathological Gambling Unit, Department of Psychiatry, Consorci Sanitari de Terrassa, Barcelona, Spain.
| | - Susana Jiménez-Murcia
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona,Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona,Spain
| | - Fernando Fernández-Aranda
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona,Spain
| | - Irene Ramos-Grille
- Pathological Gambling Unit, Department of Psychiatry, Consorci Sanitari de Terrassa, Barcelona, Spain
| | - Sara Cardona
- Pathological Gambling Unit, Department of Psychiatry, Consorci Sanitari de Terrassa, Barcelona, Spain
| | - Gemma Garrido
- Department of Psychiatry, Consorci Sanitari de Terrassa, Barcelona, Spain
| | - Mohammed Anisul Islam
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain
| | - José M Menchón
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona,Spain; CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Vicenç Vallès
- Department of Psychiatry, Consorci Sanitari de Terrassa, Barcelona, Spain
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Jiménez-Murcia S, Granero R, Fernández-Aranda F, Arcelus J, Aymamí MN, Gómez-Peña M, Tárrega S, Moragas L, Del Pino-Gutiérrez A, Sauchelli S, Fagundo AB, Brewin N, Menchón JM. Predictors of Outcome among Pathological Gamblers Receiving Cognitive Behavioral Group Therapy. Eur Addict Res 2015; 21:169-78. [PMID: 25832435 DOI: 10.1159/000369528] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 11/02/2014] [Indexed: 11/19/2022]
Abstract
AIMS The aim of this study was to evaluate posttreatment changes of individuals with a diagnosis of gambling disorder (GD) treated with group cognitive behavioral therapy (CBT), to assess the potential moderator effect of sex on CBT outcome, and to explore the best predictors of posttreatment changes, relapse, and dropout rates. METHODS A cohort design was applied with a prospective follow-up. The sample comprised 440 patients and the CBT intervention consisted of 16 weekly outpatient group sessions and a 3-month follow-up period. RESULTS Patients showed significant improvements in both the level of psychopathology and the severity of the gambling behavior. High self-transcendence and the involvement of the spouse or partner in the therapy predicted a higher risk of relapse. Younger age and low education predicted a higher risk of dropout. CONCLUSION Many patients with GD can be treated with strategies to improve self-control and emotional regulation, but other techniques should be incorporated to address the individual characteristics of each patient. This is particularly important in group therapy, in which the same treatment is applied to several patients simultaneously. The involvement of a family member needs to be carefully considered since it may have a negative effect on the response to treatment if not adequately managed.
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Affiliation(s)
- Susana Jiménez-Murcia
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
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21
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Jiménez-Murcia S, Granero R, Moragas L, Steiger H, Israel M, Aymamí N, Gómez-Peña M, Sauchelli S, Agüera Z, Sánchez I, Riesco N, Penelo E, Menchón JM, Fernández-Aranda F. Differences and Similarities Between Bulimia Nervosa, Compulsive Buying and Gambling Disorder. EUROPEAN EATING DISORDERS REVIEW 2014; 23:111-8. [DOI: 10.1002/erv.2340] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 11/21/2014] [Accepted: 11/24/2014] [Indexed: 12/22/2022]
Affiliation(s)
- Susana Jiménez-Murcia
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN); Instituto de Salud Carlos III; Madrid Spain
| | - Roser Granero
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN); Instituto de Salud Carlos III; Madrid Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut; Universitat Autònoma de Barcelona; Barcelona Spain
| | - Laura Moragas
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Howard Steiger
- Douglas Mental Health University Institute; Montreal Canada
| | - Mimi Israel
- Douglas Mental Health University Institute; Montreal Canada
| | - Neus Aymamí
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Sarah Sauchelli
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Zaida Agüera
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Isabel Sánchez
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Nadine Riesco
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
| | - Eva Penelo
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut; Universitat Autònoma de Barcelona; Barcelona Spain
| | - José M. Menchón
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- Ciber de Salud Mental (CIBERSAM); Instituto Salud Carlos III; Madrid Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry; Bellvitge University Hospital-IDIBELL; Barcelona Spain
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN); Instituto de Salud Carlos III; Madrid Spain
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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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23
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Granero R, Penelo E, Stinchfield R, Fernández-Aranda F, Aymamí N, Gómez-Peña M, Fagundo AB, Sauchelli S, Islam MA, Menchón JM, Jiménez-Murcia S. Contribution of illegal acts to pathological gambling diagnosis: DSM-5 implications. J Addict Dis 2014; 33:41-52. [PMID: 24471454 DOI: 10.1080/10550887.2014.882730] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purposes of this study were to examine the specific contribution of illegal acts to the diagnostic criteria of pathological gambling, to assess the possibility of differential item functioning across patients' sex and age, and to explore the existence of different clinical phenotypes based on the presence of illegal acts. The sample consisted of 2,155 patients seeking treatment for pathological gambling at the University Hospital of Bellvitge in Barcelona, Spain. The illegal acts item did not show different item functioning, and younger patients presented higher latent means than middle-aged and older patients, whereas no differences were found across sex. This item also showed the lowest discrimination coefficient; its exclusion would maintain satisfactory internal consistency for the remaining 9 symptoms and was poorly related to psychopathology and the severity of the gambling behavior. The relevance of the illegal acts as a diagnostic criterion appears to be limited, and its elimination from the Diagnostic and Statistical Manual for Mental Disorders, 5th edition, seems justified. However, illegal acts have implications for both the clinical and legal domains and contribute to increase the patients' impairment.
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Affiliation(s)
- Roser Granero
- a Department of Psychobiology and Methodology of Health Science , Autonomous University of Barcelona , Barcelona , Spain
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Video game addiction in gambling disorder: clinical, psychopathological, and personality correlates. BIOMED RESEARCH INTERNATIONAL 2014; 2014:315062. [PMID: 25126551 PMCID: PMC4122146 DOI: 10.1155/2014/315062] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 05/23/2014] [Accepted: 06/18/2014] [Indexed: 01/15/2023]
Abstract
OBJECTIVE We studied the prevalences of video game use (VGU) and addiction (VGA) in gambling disorder (GD) patients and compared them with subjects with non-video game use (non-VGU) in relation to their gambling behavior, psychopathology, and personality characteristics. METHOD A sample of 193 GD patients (121 non-VGU, 43 VGU, and 29 VGA) consecutively admitted to our pathological gambling unit participated in the study. Assessment. Measures included the video game dependency test (VDT), symptom checklist-90-revised, and the temperament and character inventory-revised, as well as a number of other GD indices. RESULTS In GD, the observed prevalence of VG (use or addiction) was 37.3% (95% CI :30.7% ÷ 44.3),VGU 22.3% (95% CI :17.0% ÷ 28.7), and VGA 15% (95% CI :10.7% ÷ 20.7). Orthogonal polynomial contrast into logistic regression showed positive linear trends for VG level and GD severity and other measures of general psychopathology. After structural equation modeling, higher VG total scores were associated with younger age, general psychopathology, and specific personality traits, but not with GD severity. Patients' sex and age were involved in the mediational pathways between personality traits and VG impairment. CONCLUSIONS GD patients with VG are younger and present more dysfunctional personality traits, and more general psychopathology. The presence of VG did not affect the severity of GD.
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Granero R, Penelo E, Stinchfield R, Fernandez-Aranda F, Savvidou LG, Fröberg F, Aymamí N, Gómez-Peña M, Pérez-Serrano M, del Pino-Gutiérrez A, Menchón JM, Jiménez-Murcia S. Is pathological gambling moderated by age? J Gambl Stud 2014; 30:475-92. [PMID: 23494243 DOI: 10.1007/s10899-013-9369-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The age of a patient is a strong moderator of both the course and the evolution of disorders/diseases. However, the effects of current age in pathological gambling (PG) have rarely been examined. The aim of this study is to explore the moderating effects of the patients' current age in relation to personality traits and clinical outcomes of PG. A total sample of 2,309 treatment-seeking patients for PG, diagnosed according to DSM-IV criteria, participated in this study and were assessed with the Diagnostic Questionnaire for Pathological Gambling according to DSM-IV criteria, the South Oaks Gambling Screen, the Symptom Checklist, the Temperament and Character Inventory-R, and other clinical and psychopathological measures. Orthogonal polynomial contrasts showed linear trends in the relationship between age and PG: the older the patient, the more comorbid health problems were visible. The presence of additional quadratic trends also suggests that age plays a significant role in moderating the possibility of existing PG problems and general psychopathology. No interaction term was found between age and sex, but it was present for age and some personality traits: self-transcendence and reward dependence (these two traits were only relevant to the level of impairment due to PG at specific ages). This study suggests that the patients' age influences psychopathological and clinical aspects associated to PG. Intervention in the earliest manifestations of this complex problem is essential in order to better address the need of successful treatment planning.
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Affiliation(s)
- Roser Granero
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
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Rodríguez-Cano T, Beato-Fernandez L, Rojo-Moreno L, Vaz-Leal FJ. The role of temperament and character in the outcome of depressive mood in eating disorders. Compr Psychiatry 2014; 55:1130-6. [PMID: 24666713 DOI: 10.1016/j.comppsych.2014.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 02/16/2014] [Accepted: 02/17/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The aims were to see which temperament and character dimensions were associated with depression, mainly with its outcome at two-year follow up in eating disorders (EDs). METHODS Participants (N=151) were 44 Anorexia nervosa (AN), 55 Bulimia nervosa (BN) and 52 Eating disorders not otherwise specified (EDNOS) patients. The Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI), Rosenberg Self Esteem Questionnaire (RSE), Eating Disorder Inventory (EDI-2) and Temperament and Character Inventory (TCI) were administered. RESULTS Depression at the beginning (t0) was severe in 22% of the cases. Harm Avoidance and Novelty Seeking had an effect on depressed mood at t0, mediated by Ineffectiveness. Responsibility (SD1) was associated with scores on the BDI at two-year follow up (β=-0.37, 95% CI -2.6, -0.6, p<0.01). CONCLUSION The evaluation of personality dimension in EDs has therapeutic and prognostic implications: To enhance self-efficacy and self-directness is crucial for good clinical outcome.
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Affiliation(s)
- Teresa Rodríguez-Cano
- Eating Disorders Unit, Department of Psychiatry, General Hospital of Ciudad Real, C/Obispo Torija s/n, 13005-Ciudad Real, Spain
| | - Luis Beato-Fernandez
- Eating Disorders Unit, Department of Psychiatry, General Hospital of Ciudad Real, C/Obispo Torija s/n, 13005-Ciudad Real, Spain.
| | - Luis Rojo-Moreno
- Department of Psychiatry, Faculty of Medicine, University of Valencia, Avda Blasco Ibañez nº 15, 46010-Valencia, Spain
| | - Francisco J Vaz-Leal
- Department of Psychiatry, Faculty of Medicine, University of Extremadura, Avda. De Elbas s/n, 06017-Badajoz, Spain
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Baños RM, Cebolla A, Moragrega I, Van Strien T, Fernández-Aranda F, Agüera Z, de la Torre R, Casanueva FF, Fernández-Real JM, Fernández-García JC, Frühbeck G, Gómez-Ambrosi J, Jiménez-Murcia S, Rodríguez R, Tinahones FJ, Botella C. Relationship between eating styles and temperament in an Anorexia Nervosa, Healthy Control, and Morbid Obesity female sample. Appetite 2014; 76:76-83. [DOI: 10.1016/j.appet.2014.01.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 01/07/2014] [Accepted: 01/16/2014] [Indexed: 12/15/2022]
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Gómez-Gil E, Gutiérrez F, Cañizares S, Zubiaurre-Elorza L, Monràs M, Esteva de Antonio I, Salamero M, Guillamón A. Temperament and character in transsexuals. Psychiatry Res 2013; 210:969-74. [PMID: 23958334 DOI: 10.1016/j.psychres.2013.07.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 06/17/2013] [Accepted: 07/30/2013] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate personality in transsexuals. The Temperament and Character Inventory (TCI) profiles of 166 male-to-female (MF) and 88 female-to-male (FM) transsexuals were compared with those of a control group of males and females. MF and FM transsexuals scored significantly lower than males and females in RD4 (more independent) and C3 (more self-centeredness). MF transsexuals scored higher than males and females in HA4 (more fatigable), ST and ST3 (more spiritual acceptance), and lower in C5 (more opportunistic); moreover, they showed higher scores than males in RD1 (more sentimental) and lower than females in C (less cooperativeness). FM transsexuals scored lower than females in HA2 (more daring and confident), RD (less sentimental), and C5 (more opportunistic). Compared with FM, MF transsexuals scored higher on HA2 (more fearful), RD, RD1 (more sentimental), ST, ST2 and ST3 (more spiritual). All these differences were less than half a standard deviation except for C3. Data show that transsexuals and controls display a similar personality profile, even though there are some differential personality traits. Moreover, the personality profile of transsexuals was closer to the profile of subjects who shared their gender identity than those who shared their anatomical sex.
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Affiliation(s)
- Esther Gómez-Gil
- Department of Psychiatry and Psychology, Institut Clínic of Neurosciences/IDIBAPS Hospital Clinic, Barcelona, Spain.
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Villarejo C, Jiménez-Murcia S, Álvarez-Moya E, Granero R, Penelo E, Treasure J, Vilarrasa N, Gil-Montserrat de Bernabé M, Casanueva FF, Tinahones FJ, Fernández-Real JM, Frühbeck G, de la Torre R, Botella C, Agüera Z, Menchón JM, Fernández-Aranda F. Loss of control over eating: a description of the eating disorder/obesity spectrum in women. EUROPEAN EATING DISORDERS REVIEW 2013; 22:25-31. [PMID: 24338827 DOI: 10.1002/erv.2267] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 10/08/2013] [Accepted: 10/11/2013] [Indexed: 11/11/2022]
Abstract
GOALS This study aimed to analyse the association, commonalities and differences between obesity and eating disorders (ED). METHOD A total of 150 female patients [50 obese with bulimia nervosa (OB + BN), 50 obese with binge eating disorders (OB + BED), 50 obese without eating disorders (OB)] and 50 female healthy-eating/weight control (CG) volunteers participated in this study. ASSESSMENT All participants were assessed by the Eating Disorders Inventory-2 (EDI-2), the Symptom Checklist-Revised (SCL-90-R) and the Temperament and Character Inventory-Revised. RESULTS In general, all the groups differed significantly and showed linear trends (OB + BN > OB + BED > OB > CG) on general and eating psychopathology (SCL-90-R and EDI-2). Regarding personality traits, statistically significant differences across all four groups were found on Harm Avoidance and Self-Directedness. Whereas some symptoms were shared in extreme weight conditions, others were specifically related to ED. CONCLUSIONS The presence of binge and purge symptomatology in obese patients is clinically relevant. These findings help to understand the relationship between Obesity and ED.
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Affiliation(s)
- Cynthia Villarejo
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
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Jiménez-Murcia S, Steiger H, Isräel M, Granero R, Prat R, Santamaría JJ, Moragas L, Sánchez I, Custal N, Orekhova L, Fagundo AB, Menchón J, Fernández-Aranda F. Pathological gambling in eating disorders: prevalence and clinical implications. Compr Psychiatry 2013; 54:1053-60. [PMID: 23759149 DOI: 10.1016/j.comppsych.2013.04.014] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 04/01/2013] [Accepted: 04/17/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE Pathological gambling (PG) and eating disorders (ED) rarely co-occur. We explored the prevalence of lifetime PG in ED, compared severity of ED symptoms, personality traits, and psychopathological profiles across individuals with ED and PG (ED+PG) and without PG (ED-PG). Finally, we assessed the incremental predictive value of gender on the presentation of a comorbid PG. METHOD A total sample of 1681 consecutively admitted ED patients (1576 females and 105 males), participated in the current study (25 ED+PG and 1656 ED-PG). All participants were diagnosed according to DSM-IV criteria. Assessment measures included the Symptom Checklist and the Temperament and Character Inventory-Revised, as well as other clinical and psychopathological indices. RESULTS The observed lifetime prevalence of PG was 1.49%. ED subtype was associated with lifetime PG (p=.003), with PG being more frequent in binge eating disorder (5.7%). ED+PG was more prevalent in males than in females (16% vs. 1.26%, respectively). Additionally, ED+PG patients exhibited more impulsive behaviours, lower impulse regulation and higher novelty seeking. Best predictors of ED+PG were novelty seeking (OR 1.030, p=.035), sex (OR 3.295, p=.048) and BMI (OR 1.081, p=.005). CONCLUSIONS Some personality traits (novelty seeking), being male and higher BMI are strongly related to the presence of lifetime PG in specific ED subtypes (namely binge eating disorder).
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Affiliation(s)
- Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, 08907, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain; Clinical Sciences Department, School of Medicine, University of Barcelona, Spain.
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Garcia D, Lundström S, Brändström S, Råstam M, Cloninger CR, Kerekes N, Nilsson T, Anckarsäter H. Temperament and character in the Child and Adolescent Twin Study in Sweden (CATSS): comparison to the general population, and genetic structure analysis. PLoS One 2013; 8:e70475. [PMID: 23940581 PMCID: PMC3734246 DOI: 10.1371/journal.pone.0070475] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 06/20/2013] [Indexed: 11/29/2022] Open
Abstract
Background The Child and Adolescent Twin Study in Sweden (CATSS) is an on-going, large population-based longitudinal twin study. We aimed (1) to investigate the reliability of two different versions (125-items and 238-items) of Cloninger's Temperament and Character Inventory (TCI) used in the CATSS and the validity of extracting the short version from the long version, (2) to compare these personality dimensions between twins and adolescents from the general population, and (3) to investigate the genetic structure of Cloninger's model. Method Reliability and correlation analyses were conducted for both TCI versions, 2,714 CATSS-twins were compared to 631 adolescents from the general population, and the genetic structure was investigated through univariate genetic analyses, using a model-fitting approach with structural equation-modeling techniques based on same-sex twin pairs from the CATSS (423 monozygotic and 408 dizygotic pairs). Results The TCI scores from the short and long versions showed comparable reliability coefficients and were strongly correlated. Twins scored about half a standard deviation higher in the character scales. Three of the four temperament dimensions (Novelty Seeking, Harm Avoidance, and Persistence) had strong genetic and non-shared environmental effects, while Reward Dependence and the three character dimensions had moderate genetic effects, and both shared and non-shared environmental effects. Conclusions Twins showed higher scores in character dimensions compared to adolescents from the general population. At least among adolescents there is a shared environmental influence for all of the character dimensions, but only for one of the temperament dimensions (i.e., Reward Dependence). This specific finding regarding the existence of shared environmental factors behind the character dimensions in adolescence, together with earlier findings showing a small shared environmental effects on character among young adults and no shared environmental effects on character among adults, suggest that there is a shift in type of environmental influence from adolescence to adulthood regarding character.
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Affiliation(s)
- Danilo Garcia
- Centre for Ethics, Law and Mental Health, University of Gothenburg, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- * E-mail:
| | - Sebastian Lundström
- Centre for Ethics, Law and Mental Health, University of Gothenburg, Gothenburg, Sweden
- Swedish Prison and Probation Service, Research & Devolopment unit, Gothenburg, Sweden
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sven Brändström
- Centre for Ethics, Law and Mental Health, University of Gothenburg, Gothenburg, Sweden
| | - Maria Råstam
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - C. Robert Cloninger
- Departments of Psychiatry & Genetics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, United States of America
| | - Nóra Kerekes
- Centre for Ethics, Law and Mental Health, University of Gothenburg, Gothenburg, Sweden
- Swedish Prison and Probation Service, Research & Devolopment unit, Gothenburg, Sweden
| | - Thomas Nilsson
- Centre for Ethics, Law and Mental Health, University of Gothenburg, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Henrik Anckarsäter
- Centre for Ethics, Law and Mental Health, University of Gothenburg, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Sciences, Lund University, Malmö, Sweden
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Bueno B, Krug I, Bulik CM, Jiménez-Murcia S, Granero R, Thornton L, Penelo E, Menchón JM, Sánchez I, Tinahones FJ, Fernández-Aranda F. Late onset eating disorders in Spain: clinical characteristics and therapeutic implications. J Clin Psychol 2013; 70:1-17. [PMID: 23801539 DOI: 10.1002/jclp.22006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The literature on later age of onset (LAO) in women with eating disorders is scarce. We compared the severity of eating disorders, eating disorder subtype, and personality profiles in a clinical sample of consecutively assessed women with eating disorders with later age of onset (LAO, > = 25 years) to women with typical age of onset (TAO, <25 years). METHOD All eating disorder patients met the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) criteria and were admitted to the Eating Disorder Unit of the University Hospital of Bellvitge in Barcelona, Spain. Ninety-six patients were classified as LAO and 759 as TAO. ASSESSMENT Measures included the Eating Attitude Test-40 (EAT-40), Eating Disorders Inventory-2 (EDI-2), Bulimic Investigatory Test Edinburgh (BITE), Symptom Checklist Revised (SCL-90-R), and the Temperament and Character Inventory-Revised (TCI-R), as well as other clinical and psychopathological indices. RESULTS LAO individuals reported significantly fewer weekly vomiting episodes, fewer self-harming behaviours, less drug abuse, and lower scores on the BITE symptoms, the EDI-2 drive for thinness, and the TCI-R harm avoidance scales than TAO individuals. Conversely, the LAO group reported more current and premorbid obesity than the TAO group. CONCLUSION LAO eating disorder patients in this sample presented with milder symptomatology and less extreme personality traits. Premorbid obesity may be more relevant to LAO than TAO eating disorders and should be routinely assessed and considered when planning treatment.
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Affiliation(s)
- B Bueno
- Department of Psychiatry, University Hospital of Bellvitge; CIBER Salud Mental (CIBERSAM), ISCIII
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Permanyer-Miralda G, Adam P, Guillamón I, Solans-Domènech M, Pons JMV. Characteristics of Spanish articles of "scientific quality" cited in clinical practice guidelines on mental health. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2013; 6:150-9. [PMID: 23395541 DOI: 10.1016/j.rpsm.2012.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 11/01/2012] [Accepted: 11/06/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The study aims to illustrate the impact of Spanish research in clinical decision making. To this end, we analysed the characteristics of the most significant Spanish publications cited in clinical practice guidelines (CPG) on mental health. MATERIAL AND METHODS We conducted a descriptive qualitative study on the characteristics of ten articles cited in Spanish CPG on mental health, and selected for their "scientific quality". We analysed the content of the articles on the basis of the following characteristics: topics, study design, research centres, scientific and practical relevance, type of funding, and area or influence of the reference to the content of the guidelines. RESULTS Among the noteworthy studies, some basic science studies, which have examined the establishment of genetic associations in the pathogenesis of mental illness are included, and others on the effectiveness of educational interventions. The content of those latter had more influence on the GPC, because they were cited in the summary of the scientific evidence or in the recommendations. Some of the outstanding features in the selected articles are the sophisticated designs (experimental or analytical), and the number of study centres, especially in international collaborations. Debate or refutation of previous findings on controversial issues may have also contributed to the extensive citation of work. CONCLUSIONS The inclusion of studies in the CPG is not a sufficient condition of "quality", but their description can be instructive for the design of future research or publications.
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Affiliation(s)
- Gaietà Permanyer-Miralda
- Unidad de Epidemiología, Servicio de Cardiología, Hospital Universitario Vall Hebron, Barcelona, España; Agència d'Informació, Avaluació i Qualitat en Salut, (Agència de Qualitat i Avaluació Sanitàries de Catalunya), Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, España
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Lee HS, Lee SK, Lee HP, Kim YK. State effect of traumatic experience on personality structure. Psychiatry Investig 2012; 9:361-7. [PMID: 23251200 PMCID: PMC3521112 DOI: 10.4306/pi.2012.9.4.361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 03/05/2012] [Accepted: 03/27/2012] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Personality is defined as the trait-like qualities of a person. However, it has been recently suggested that the state effect of a situation leads to changes in scores on personality assessments. We predicted that traumatic experiences would induce changes not only in personality scores but also in the factor structures of personality assessments. METHODS MethodsaaWe conducted a cross-sectional, case-controlled study using two data sets: a traumatized adolescent sample (n=71) and a non-traumatized adolescent sample (n=296). Personality factor structures were compared between the two samples using exploratory factor analyses for 25 lower-ordered subscales of the Temperament and Character Inventory (TCI). In the non-traumatized sample, evaluation of the scree plot suggested a five-factor solution supporting TCI's original seven-factor model. RESULTS The traumatized sample showed a three-factor structure representing a biological factor, a social factor and an existential factor. This decrease in number of personality factors was caused by strengthened correlations among personality subscales related to coping with traumatic situations. Cloninger's psychobiological model of personality (i.e., temperament-character) was adequate in capturing personality traits of non-traumatized adolescents, but the tripartite view of existential psychology (i.e., body-mind-spirit) clearly corresponded to the factor structure of the traumatized adolescents. CONCLUSION The three-factor solution of the present traumatized group is consistent with the tripartite model of personality (i.e., body-mind-spirit), while the five-factor solution of the non-traumatized group corresponds to Cloninger's seven-factor model. This is the first study to describe the state effects of traumatic experiences on personality structure.
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Affiliation(s)
- Hong-seock Lee
- Department of Psychiatry, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea
| | - Sang-Kyu Lee
- Department of Psychiatry, Kangnam Sacred Heart Hospital, Hallym University Medical Center, Seoul, Republic of Korea
| | - Heung-Pyo Lee
- Department of Psychology, Daegu Cyber University, Daegu, Republic of Korea
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University College of Medicine, Ansan Hospital, Ansan, Republic of Korea
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Claes L, Jiménez-Murcia S, Santamaría JJ, Moussa MB, Sánchez I, Forcano L, Magnenat-Thalmann N, Konstantas D, Overby ML, Nielsen J, Bults RGA, Granero R, Lam T, Kalapanidas E, Treasure J, Fernández-Aranda F. The facial and subjective emotional reaction in response to a video game designed to train emotional regulation (Playmancer). EUROPEAN EATING DISORDERS REVIEW 2012; 20:484-9. [PMID: 23097370 DOI: 10.1002/erv.2212] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Several aspects of social and emotional functioning are abnormal in people with eating disorders. The aim of the present study was to measure facial emotional expression in patients with eating disorders and healthy controls whilst playing a therapeutic video game (Playmancer) designed to train individuals in emotional regulation. Participants were 23 ED patients (11 AN, 12 BN) and 11 HCs. ED patients self reported more anger at baseline but expressed less facial expression of anger during the Playmancer game. The discrepancy between self-report and non-verbal expression may lead to problems in social communication.
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Affiliation(s)
- Laurence Claes
- Department of Psychology, Catholic University of Leuven, Belgium
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Gambling on the stock market: an unexplored issue. Compr Psychiatry 2012; 53:666-73. [PMID: 22300903 DOI: 10.1016/j.comppsych.2011.12.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 12/07/2011] [Accepted: 12/13/2011] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Stock market investment (SMI) is one of the most socially acceptable types of gambling, which, however, can turn into a gambling problem. Because it is barely examined, we compared a series of clinical, psychopathologic, and personality variables in SMI gambling patients (both as primary and secondary problem) with a group of traditional pathologic gamblers (PGs). METHOD A total sample of 1470 PGs (1376 patients without SMIs [PG-SMI], 76 patients with SMI as a secondary gambling problem [PG+SMI], and 18 patients with SMI as a primary gambling problem [SMI+PG]) participated in this study. All participants were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. The following instruments were used: the South Oaks Gambling Screen, the Symptom Check List-90 Items-Revised, the Temperament and Character Inventory-Revised, and other clinical and psychopathologic indices. RESULTS The 3 patient groups' profiles were statistically similar in psychometrical measures. The risk of having SMI increased for patients with higher education, and the presence of SMI as a primary problem in PGs increased with university study level and higher scores on the personality trait of cooperativeness. CONCLUSIONS The results of this study indicate comparability of SMI gamblers with PGs in their general clinical profile and in psychopathology and personality.
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Gómez-Peña M, Penelo E, Granero R, Fernández-Aranda F, Álvarez-Moya E, Santamaría JJ, Moragas L, Neus Aymamí M, Gunnard K, Menchón JM, Jimenez-Murcia S. Correlates of Motivation to Change in Pathological Gamblers Completing Cognitive-Behavioral Group Therapy. J Clin Psychol 2012; 68:732-44. [DOI: 10.1002/jclp.21867] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - Eva Penelo
- Laboratori d'Estadística Aplicada; Psicobiologia i Metodologia; Universitat Autònoma de Barcelona
| | - Roser Granero
- Laboratori d'Estadística Aplicada; Psicobiologia i Metodologia; Universitat Autònoma de Barcelona
| | | | | | | | - Laura Moragas
- Psychiatry; Bellvitge University Hospital; Barcelona
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Villarejo C, Fernández-Aranda F, Jiménez-Murcia S, Peñas-Lledó E, Granero R, Penelo E, Tinahones FJ, Sancho C, Vilarrasa N, Montserrat-Gil de Bernabé M, Casanueva FF, Fernández-Real JM, Frühbeck G, De la Torre R, Treasure J, Botella C, Menchón JM. Lifetime obesity in patients with eating disorders: increasing prevalence, clinical and personality correlates. EUROPEAN EATING DISORDERS REVIEW 2012; 20:250-4. [PMID: 22383308 PMCID: PMC3510304 DOI: 10.1002/erv.2166] [Citation(s) in RCA: 139] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The aims of our study were to examine the lifetime prevalence of obesity rate in eating disorders (ED) subtypes and to examine whether there have been temporal changes among the last 10 years and to explore clinical differences between ED with and without lifetime obesity. METHODS Participants were 1383 ED female patients (DSM-IV criteria) consecutively admitted, between 2001 and 2010, to Bellvitge University Hospital. They were assessed by means of the Eating Disorders Inventory-2, the Symptom Checklist-90-Revised, the Bulimic Investigatory Test Edinburgh and the Temperament and Character Inventory-Revised. RESULTS The prevalence of lifetime obesity in ED cases was 28.8% (ranging from 5% in anorexia nervosa to 87% in binge-eating disorders). Over the last 10 years, there has been a threefold increase in lifetime obesity in ED patients (p < .001). People with an ED and obesity had higher levels of childhood and family obesity (p < .001), a later age of onset and longer ED duration; and had higher levels of eating, general and personality symptomatology. CONCLUSIONS Over the last 10 years, the prevalence of obesity associated with disorders characterized by the presence of binge episodes, namely bulimic disorders, is increasing, and this is linked with greater clinical severity and a poorer prognosis.
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Affiliation(s)
- Cynthia Villarejo
- Department of Psychiatry, University Hospital of Bellvitge—IDIBELLBarcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge—IDIBELLBarcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos IIISpain
- Clinical Sciences Department, University of BarcelonaSpain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge—IDIBELLBarcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos IIISpain
- Clinical Sciences Department, University of BarcelonaSpain
| | | | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos IIISpain
- Laboratori d'Estadística Aplicada, Departament de Psicobiologia i Metodologia, Universitat Autònoma de BarcelonaSpain
| | - Eva Penelo
- Laboratori d'Estadística Aplicada, Departament de Psicobiologia i Metodologia, Universitat Autònoma de BarcelonaSpain
| | - Francisco J Tinahones
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos IIISpain
- Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de VictoriaMálaga, Spain
| | - Carolina Sancho
- Department of Psychiatry, University Hospital of Bellvitge—IDIBELLBarcelona, Spain
| | - Nuria Vilarrasa
- Endocrinology and Nutrition Department, Bellvitge Universitary Hospital—IDIBELLBarcelona, Spain
| | | | - Felipe F Casanueva
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos IIISpain
- Division of Endocrinology, Complejo Hospitalario Universitario de Santiago de CompostelaSpain
| | - Jose Manuel Fernández-Real
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos IIISpain
- Department of Diabetes, Endocrinology and Nutrition, Institut d'Investigació Biomèdica de Girona (IdlBGi) Hospital Dr Josep TruetaGirona, Spain
| | - Gema Frühbeck
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos IIISpain
- Department of Endocrinology and Nutrition, University of NavarraPamplona, Spain
| | - Rafael De la Torre
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos IIISpain
- Human Pharmacology and Clinical Neurosciences Research Group, Neuroscience Research Program, IMIM—Hospital del Mar Research InstituteBarcelona, Spain
| | - Janet Treasure
- Institute of Psychiatry, Psychological Medicine, Section of Eating Disorders, King's College LondonLondon, UK
| | - Cristina Botella
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos IIISpain
- University Jaume ICastellón, Spain
| | - José Manuel Menchón
- Department of Psychiatry, University Hospital of Bellvitge—IDIBELLBarcelona, Spain
- Clinical Sciences Department, University of BarcelonaSpain
- CIBER, Salud Mental (CIBERSAM), Instituto Carlos IIISpain
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Arias B, Aguilera M, Moya J, Sáiz PA, Villa H, Ibáñez MI, García-Portillo MP, Bobes J, Ortet G, Fañanás L. The role of genetic variability in the SLC6A4, BDNF and GABRA6 genes in anxiety-related traits. Acta Psychiatr Scand 2012; 125:194-202. [PMID: 21902679 DOI: 10.1111/j.1600-0447.2011.01764.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The aims of this study were to test the individual association of the serotonin transporter gene (SLC6A4), the brain-derived neurotrophic factor gene (BDNF) and the GABA(A) α(6) receptor subunit gene (GABRA6) with anxiety-related traits and to explore putative gene-gene interactions in a Spanish healthy sample. METHOD A sample of 937 individuals from the general population completed the Temperament and Character Inventory questionnaire to explore Harm Avoidance (HA) dimension; a subsample of 553 individuals also filled in the Big Five Questionnaire to explore the Neuroticism dimension. The whole sample was genotyped for the 5-HTTLPR polymorphism (SLC6A4 gene), the Val66Met polymorphism (BDNF gene) and the T1521C polymorphism (GABRA6 gene). RESULTS Homozygous individuals for the T allele of the T1512C polymorphism presented slightly higher scores for HA than C allele carriers (F = 2.96, P = 0.019). In addition, there was a significant gene-gene interaction on HA between the 5-HTTLPR and Val66Met polymorphisms (F = 3.4, P = 0.009). CONCLUSION GABRA6 emerges as a candidate gene involved in the variability of HA. The effect of a significant gene-gene interaction between the SLC6A4 and BDNF genes on HA could explain part of the genetic basis underlying anxiety-related traits.
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Affiliation(s)
- B Arias
- Department of Animal Biology, Anthropology Section, Faculty of Biology, University of Barcelona, Spain
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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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Smith TL, Klein MH, Alonso C, Salazar-Fraile J, Felipe-Castaño E, Moreno CL, Acosta SR, Rios LI, Martí-Sanjuán V. The Spanish version of the Wisconsin Personality Disorders Inventory-IV (WISPI-IV): tests of validity and reliability. J Pers Disord 2011; 25:813-33. [PMID: 22217227 DOI: 10.1521/pedi.2011.25.6.813] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Personality disorders (PD) are a prevalent class of mental disorders that interfere with functioning and cause subjective distress while increasing the intensity and duration of Axis I clinical syndromes, and therefore assessing PD is important even when PDs are not the focus of treatment. The purpose of these studies was to develop and test a new Spanish version of a self-report measure of PD, the Wisconsin Personality Inventory-IV (WISPI-IV) that would be psychometrically equivalent to the English version while also maintaining the same interpersonal content, which is based on Benjamin's analysis of the PD criteria using her Structural Analysis of Social Behavior (SASB) model (1974). Study 1 participants completed the WISPI-IV twice over a two-week interval. For Study 2, participants from two sites in Spain and one site in Argentina completed Spanish versions of the WISPI-IV and other personality measures. SASB-analysis of the translated items showed high correspondence between the interpersonal content of the English version and the Spanish version demonstrating theoretical validation in relation to other PD measures. The Spanish WISPI-IV showed satisfactory reliability based on test-retest correlations and alphas for internal consistency. Study 2 showed the Spanish WISPI-IV had good convergent validity with the Spanish versions of the IIP and SCID-II and performed similarly to the English versions of these measures. Our goal in translating the WISPI-IV was to extend this measure to Spanish-speakers in language that would be understood by different Hispanic sub-groups, however research team members and subjects had a variety of suggestions for changes in item wording. This reflects the difficulty with creating a "neutral" Spanish version of any assessment given regional differences.
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Affiliation(s)
- Tracey L Smith
- University of Wisconsin, Dept. of Psychiatry, Madison, WI 53719, USA.
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Jiménez-Murcia S, Stinchfield R, Fernández-Aranda F, Santamaría JJ, Penelo E, Granero R, Gómez-Peña M, Aymamí N, Moragas L, Soto A, Menchón JM. Are online pathological gamblers different from non-online pathological gamblers on demographics, gambling problem severity, psychopathology and personality characteristics? INTERNATIONAL GAMBLING STUDIES 2011. [DOI: 10.1080/14459795.2011.628333] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Núñez-Navarro A, Jiménez-Murcia S, Alvarez-Moya E, Villarejo C, Díaz IS, Augmantell CM, Granero R, Penelo E, Krug I, Tinahones FJ, Bulik CM, Fernández-Aranda F. Differentiating purging and nonpurging bulimia nervosa and binge eating disorder. Int J Eat Disord 2011; 44:488-96. [PMID: 20872757 DOI: 10.1002/eat.20823] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2010] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore similarities and differences in clinical and personality variables across three groups: binge eating disorder (BED), bulimia nervosa-purging type (BN-P), and bulimia nervosa-non purging type (BN-NP). METHOD The participants were 102 female eating disorders patients (34 BED, 34 BN-P, and 34 BN-NP) consecutively admitted to the eating disorders unit, at the University Hospital of Bellvitge, and diagnosed according to DSM-IV criteria. RESULTS BED patients were older, and more likely to have personal and family history of obesity. A gradient in psychopathological scores emerged with BN-P patients having higher pathological scores on the SCL-90-R, followed by BN-NP and BED patients. No statistically significant differences were observed in personality traits. DISCUSSION Our data supported that eating disorders (namely BED, BN-NP, and BN-P) followed a linear trend in general psychopathology. Whereas personality may represent a shared vulnerability factor, differences in clinical severity suggest there to be a continuum with BN-P being the most severe and BED being the least severe.
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Affiliation(s)
- Araceli Núñez-Navarro
- Department of Psychiatry, University Hospital of Bellvitge, Feixa Llarga s/n, PC: 08907 Barcelona, Spain
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Núñez-Navarro A, Agüera Z, Krug I, Jiménez-Murcia S, Sánchez I, Araguz N, Gorwood P, Granero R, Penelo E, Karwautz A, Moragas L, Saldaña S, Treasure J, Menchón JM, Fernández-Aranda F. Do men with eating disorders differ from women in clinics, psychopathology and personality? EUROPEAN EATING DISORDERS REVIEW 2011; 20:23-31. [PMID: 21823213 DOI: 10.1002/erv.1146] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To determine if male and female eating disorders differ in clinics, psychopathology and personality traits when compared with a healthy group. METHODS Sixty male and 60 female eating disorder individuals (16% anorexia nervosa, 42% bulimia nervosa and 42% eating disorder not otherwise specified), matched for age and diagnostic, were compared with 120 healthy-eating participants (60 male and 60 female participants). All were diagnosed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Assessment measures included Eating Disorder Inventory--2, Symptom Checklist--Revised and Temperament and Character Inventory--Revised, as well as other clinical and psychopathological indices. RESULTS Male eating disorder participants reported significant lower laxative abuse (p = 0.020) and significant higher vomiting episodes (p = 0.019) than female eating disorder participants. Differences on drive for thinness, body dissatisfaction and some Symptom Checklist--Revised scales were found across genders in eating disorder participants. Male eating disorder participants scored significantly lower than female participants with eating disorders on harm avoidance, reward dependence and cooperativeness. CONCLUSIONS Although eating disorder clinical features were similar across genders, male eating disorder participants had less body image concern and general psychopathology than female eating disorder participants.
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Affiliation(s)
- Araceli Núñez-Navarro
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
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Forcano L, Alvarez E, Santamaría JJ, Jimenez-Murcia S, Granero R, Penelo E, Alonso P, Sánchez I, Menchón JM, Ulman F, Bulik CM, Fernández-Aranda F. Suicide attempts in anorexia nervosa subtypes. Compr Psychiatry 2011; 52:352-8. [PMID: 21683172 DOI: 10.1016/j.comppsych.2010.09.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 09/13/2010] [Accepted: 09/16/2010] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE The risk for suicide attempts is elevated in anorexia nervosa (AN), yet we know little about the relation between suicide and personality in this group. We explored the prevalence of lifetime suicide attempts in women with AN and compared those who had and had not attempted suicide on eating disorder symptoms, general psychopathology, and personality both relative to a healthy control group and then across AN subtypes. METHOD One hundred four outpatients with restricting AN, 68 outpatients with purging AN, and 146 comparison individuals participated in the study. RESULTS The prevalence of suicide attempts differed significantly across the 3 groups (P = .003), with 0% in the controls, 8.65% in the restricting AN group, and 25.0% in the purging AN group. Depression measures were elevated in those with suicide attempts. Within the restricting AN group, those who attempted suicide scored significantly higher on Phobic Anxiety, measured by means of the Symptom Checklist-Revised, than those who did not (P = .001). CONCLUSION The presence of purging and depressive symptoms in individuals with AN should increase vigilance for suicidality; and among restrictors, greater anxiety may index greater suicide risk.
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Affiliation(s)
- Laura Forcano
- Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III, Barcelona, Spain
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Mendoza L, Navinés R, Crippa JA, Fagundo AB, Gutierrez F, Nardi AE, Bulbena A, Valdés M, Martín-Santos R. Depersonalization and personality in panic disorder. Compr Psychiatry 2011; 52:413-9. [PMID: 21683177 DOI: 10.1016/j.comppsych.2010.09.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 09/10/2010] [Accepted: 09/17/2010] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Prevalence and clinical correlates of depersonalization symptoms have been associated with panic disorder. Personality traits might increase the likelihood of experiencing depersonalization symptoms or depersonalization disorder in panic patients. AIMS The objectives of this study are to establish the prevalence of depersonalization symptoms during the panic attack and in depersonalization disorder and to examine the personality factors associated with the presence of depersonalization in patients with panic disorder. METHODS The sample comprised 104 consecutive adult outpatients with panic disorder, diagnosed according to the Semistructured Clinical Interview for DSM-IV (Axis I/II disorders). Participants were assessed with the Cambridge Depersonalization Scales, the Temperament and Character Inventory, and the Panic and Agoraphobia Scale. RESULTS Forty-eight percent of the sample had depersonalization symptoms during the panic attack, whereas 20% of patients had a depersonalization disorder. Women presented more depersonalization disorders than did men (P = .036). Patients with panic disorder with depersonalization disorder had a more severe panic disorder (P = .002). Logistic regression analysis showed that self-transcendence trait (odds ratio, 1.089; 95% confidence interval, 1.021-1.162; P = .010) and severity of panic (odds ratio, 1.056; 95% confidence interval, 1.005-1.110; P = .032) were independently associated with depersonalization disorder. CONCLUSIONS A high prevalence of depersonalization symptoms and depersonalization disorder was confirmed in patients with panic disorder, supporting a dosage effect model for understanding depersonalization pathology. Self-transcendence trait and severity of panic disorder were reported as risk factors for depersonalization disorder.
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Affiliation(s)
- Lilian Mendoza
- Institute of Neuroscience, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, University of Barcelona, Spain
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Jimenez-Murcia S, Aymamí N, Gómez-Peña M, Santamaría JJ, Alvarez-Moya E, Fernández-Aranda F, Granero R, Penelo E, Bueno B, Moragas L, Gunnard K, Menchón JM. Does exposure and response prevention improve the results of group cognitive-behavioural therapy for male slot machine pathological gamblers? BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2011; 51:54-71. [PMID: 22268541 DOI: 10.1111/j.2044-8260.2011.02012.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Cognitive-behavioural therapy (CBT) seems to offer effective treatment for pathological gambling (PG). However, it has not yet been established which techniques yield the best results, or whether exposure and response prevention (ERP) techniques are of additional use. OBJECTIVES To evaluate clinical and socio-demographic characteristics of a PG sample at baseline, comparing cognitive-behavioural group intervention, with and without exposure, with response prevention (CBT + ERP vs. CBT), to compare the results of therapy and to assess pre-post changes in psychopathology between both groups. DESIGN We applied a quasi-experimental design comprising intervention on the independent variable, but without random assignment. METHODS The sample comprised 502 males with PG, consecutively admitted to a specialist unit, who received standardized outpatient CBT group therapy in 16 weekly sessions. Scores on the Symptom Checklist-Revised (SCL-90-R), the Temperament and Character Inventory-Revised (TCI-R), the South Oaks Gambling Screen (SOGS), and other clinical and psychopathological scales were recorded. RESULTS Pre-post changes did not differ between groups, except for SCL paranoid ideation, being greater in the CBT therapy group. The risk of relapse during treatment was similar in the CBT + ERP and CBT patients. However, compliance with treatment was poorer in the CBT + ERP group, who presented higher drop-out rates during treatment. Drop-out during therapy was associated with shorter disorder duration and higher scores on the TCI-R novelty seeking scale. CONCLUSIONS Although the two CBT programs elicited similar therapy responses, patients receiving CBT alone showed higher adherence to therapy and lower drop-out rates.
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Gómez-Peña M, Penelo E, Granero R, Fernández-Aranda F, Alvarez-Moya E, Santamaría JJ, Moragas L, Aymamí MN, Bueno B, Gunnard K, Menchón JM, Jiménez-Murcia S. Motivation to change and pathological gambling: analysis of the relationship with clinical and psychopathological variables. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2011; 50:196-210. [PMID: 21545451 DOI: 10.1348/014466510x511006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES. The present study analyses the internal factor structure of the University of Rhode Island Change Assessment (URICA) Scale in pathological gambling (PG). The scale's association with the clinical profile of patients is also evaluated. METHOD. The factor analysis was based on a sample of 531 men with a DSM-IV diagnosis of pathological gambling. The statistical analysis included confirmatory factor analysis and linear correlation. RESULTS. The analyses confirmed the internal structure obtained for the URICA. The internal consistency was satisfactory (Cronbach's alpha between .74 and .85). The association between URICA scores and the socio-demographic and clinical profile of patients ranged between moderate and weak (R coefficients below .30). Lower motivation was present in 28.4% of cases and it was associated with shorter duration of the disorder, lower severity of the PG symptoms, and high psychopathology. Conclusions. The results support the validity and reliability of the URICA in a Spanish clinical population of pathological gamblers.
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Affiliation(s)
- Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
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Jiménez-Murcia S, Alvarez-Moya EM, Stinchfield R, Fernández-Aranda F, Granero R, Aymamí N, Gómez-Peña M, Jaurrieta N, Bove F, Menchón JM. Age of onset in pathological gambling: clinical, therapeutic and personality correlates. J Gambl Stud 2010; 26:235-48. [PMID: 20063194 DOI: 10.1007/s10899-009-9175-3] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We aimed to explore the association between age of onset of gambling problems and current psychopathological and clinical status, personality profile and therapeutic outcome in a sample of pathological gamblers. A total of 904 consecutive pathological gambling patients were administered several instruments about gambling behavior, psychopathology and personality. They received a 4-month cognitive-behavioral group treatment. Information of dropouts and relapses during treatment was registered. Older age of onset of gambling problems was associated with higher general psychopathology (SCL-90-R Paranoid Ideation, Psychoticism, Depression; P < 0.015). Younger age of onset was related to greater severity of pathological gambling (P < 0.015), higher novelty seeking, and lower self-directedness (P < 0.015). No statistically significant association was found between age of onset and relapse and dropouts during treatment. Age of onset of gambling problems seems to influence the clinical presentation of pathological gambling but not treatment outcome.
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Affiliation(s)
- Susana Jiménez-Murcia
- Department of Psychiatry, Pathological Gambling Unit, Bellvitge University Hospital, C/Feixa Llarga, s/n L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
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Chotai J, Joukamaa M, Taanila A, Lichtermann D, Miettunen J. Novelty seeking among adult women is lower for the winter borns compared to the summer borns: replication in a large Finnish birth cohort. Compr Psychiatry 2009; 50:562-6. [PMID: 19840595 DOI: 10.1016/j.comppsych.2008.11.010] [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: 06/14/2008] [Revised: 11/06/2008] [Accepted: 11/16/2008] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Earlier general population studies have shown that novelty seeking (NS) of the Temperament and Character Inventory (TCI) of personality is lower for persons born in winter compared to those born in summer, particularly for women. Here, we investigate if this result can be replicated in another population. METHOD The Northern Finland 1966 Birth Cohort, comprising 4968 subjects (2725 women, 2243 men), was investigated with regard to the temperament dimensions of the TCI and the season of birth. RESULTS Novelty seeking and reward dependence (RD) showed significant variations according to the month of birth. We found that women born during winter have significantly lower levels of NS compared to women born during summer, with a minimum for the birth month November and maximum for May. These results are similar to those found in a previous Swedish study. Furthermore, our study showed that men born during spring had significantly lower mean scores of RD compared to men born during autumn, with a minimum for birth month March. This was in contrast to the Swedish study, where the minimum of RD was obtained for the birth month December. CONCLUSION Women born in winter have lower NS as adults compared to women born in summer. Because NS is modulated by dopamine, this study gives further support to the studies in the literature that show that dopamine turnover for those born in winter is higher than for those born in summer.
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Affiliation(s)
- Jayanti Chotai
- Division of Psychiatry, Department of Clinical Sciences, University of Umeå, 901 85 Umeå, Sweden.
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