Agreement between informant and self-reported personality in depressed older adults: what are the roles of medical illness and cognitive function?

Personality traits and disorders in Alzheimer's disease

BACKGROUND

The relationships between axis II personality disorders and the normative personality traits were explored in the context of current and pre-morbid personality assessment in Alzheimer's disease (AD).

METHODS

The study was conducted with four groups who were administered the NEO-FFI and the PDQ-4+, in the form of individual interview sessions. Current personality measure: consisting of 44 female participants (AD group) and, the control group, consisting of 80 female participants from the population at large. Pre-morbid personality measure: AD group informants (n = 40); control group informants (n = 42).

RESULTS

The results are in line with the literature review and provide new research data. By factorial discriminant analysis, the current and pre-morbid personality variables that differentiate AD from control groups are identified. The personality traits variables are the best discriminators such as low agreeableness, low openness to experience, and high neuroticism, suggesting that the maladaptive personality functioning can be described extending the range of psychopathology to a dimensional approach.

CONCLUSIONS

The study of personality variables seems to suggest, in their inclusion, the possibility to increase sensitivity toward an assessment in AD.

Personality and Alzheimer's disease: An integrative review

The objective of this article is to review and integrate interrelated areas of research on personality and Alzheimer's disease (AD). Prospective studies indicate that individuals who score higher on conscientiousness (more responsible and self-disciplined) and lower on neuroticism (less anxious and vulnerable to stress) have a reduced risk of developing dementia, even in the presence of AD neuropathology. Personality is also related to measures of cognitive performance and cognitive decline, with effect sizes similar to those of other clinical, lifestyle, and behavioral risk factors. These associations are unlikely to be due to reverse causality: Long-term prospective data indicate that there are no changes in personality that are an early sign of the disease during the preclinical phase of AD. With the onset and progression of dementia, however, there are large changes in personality that are reported consistently by caregivers in retrospective studies and are consistent with the clinical criteria for the diagnosis of dementia. The review also discusses potential mechanisms of the observed associations and emphasizes the need for prospective studies to elucidate the interplay of personality traits with AD neuropathology (amyloid and tau biomarkers) in modulating the risk and timing of onset of clinical dementia. The article concludes with the implications of personality research for identifying those at greater risk of AD and the potential of personality-tailored interventions aimed at the prevention and treatment of AD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A new perspective on proxy report: Investigating implicit processes of understanding through patient-proxy congruence

BACKGROUND

Utilizing proxy report is a common solution to gathering quality-of-life information from people who are not capable of reliably answering questionnaires, such as people with dementia. Proxy report could, however, also provide information about patients' implicit processes of understanding, which we define as automatic, schema-driven cognitive processes that allow one to have a better understanding of oneself and of one's body, make oneself known and knowable to members of the social network, and allow one to react proactively in response to cues. We investigated whether implicit processes of understanding explain some of the association between reserve and healthy lifestyle behaviors.

METHODS

We operationalized three implicit processes of understanding: (a) psychosocial understanding; (b) insight into physical disability; and (c) somatic awareness. This secondary analysis involved a cohort of multiple sclerosis patients and their caregiver informants (n = 118 pairs). Measures included a neurologist-administered Expanded Disability Status Scale, patient- and informant-completed survey measures, and a heartbeat perception test (interoception). Patient-other congruence assessed implicit processes of understanding: psychosocial understanding (neurocognitive and personality); physical-disability insight; and somatic awareness (interoception).

RESULTS

Effect sizes (ES) for the inter-correlations between the three implicit processes were small. Psychosocial understanding was associated with higher past reserve-building activities (small ES). Psychosocial understanding explained variance in healthy lifestyle behaviors over and above the variance explained by current reserve-building activities (∆R (2) = 0.04; model R Adjusted (2) = 0.18).

CONCLUSIONS

Proxy versus patient report can provide information about underlying interpretational processes related to insight. These processes are distinct from reserve, predict health outcomes, and can inform lifestyle-changing interventions.

Personality Change Pre- to Post- Loss in Spousal Caregivers of Patients with Terminal Lung Cancer

Personality is relatively stable in adulthood but could change in response to life transitions, such as caring for a spouse with a terminal illness. Using a case-control design, spousal caregivers (n=31) of patients with terminal lung cancer completed the NEO-FFI twice, 1.5 years apart, before and after the patient's death. A demographically-matched sample of community controls (n=93) completed the NEO-FFI on a similar timeframe. Based on research and theory, we hypothesized that bereaved caregivers would experience greater changes than controls in interpersonal facets of extraversion (sociability), agreeableness (prosocial, nonantagonistic), and conscientiousness (dependability). Consistent with hypotheses, bereaved caregivers experienced an increase in interpersonal orientation, becoming more sociable, prosocial, and dependable (Cohen's d = .48-.67), though there were no changes in nonantagonism. Changes were not observed in controls (ds ≤ .11). These initial findings underscore the need for more research on the effect of life transitions on personality.

Linking concurrent self-reports and retrospective proxy reports about the last year of life: a prevailing picture of life satisfaction decline

OBJECTIVE

We examined the extent to which retrospective proxy reports of well-being mirror participant self-reports at 12-24 months before death and how proxy reports of well-being change over the last year of life. We also explored the role of sociodemographic, cognitive, and health factors of both participants and proxies in moderating such associations.

METHOD

We used retrospective proxy ratings obtained in the German Socio-Economic Panel Study (N = 164; age at death = 19-99 years).

RESULTS

Results revealed moderate agreement between self- and proxy reports (r = .42), but proxies, on average, overestimated participants' life satisfaction by two thirds of a scale point on a 0-10 scale (or 0.4 SD). Discrepancies were particularly pronounced when proxies themselves reported low life satisfaction. Over the last year of life, participants were viewed to have experienced declines in life satisfaction (-0.54 SD). Declines were stronger for ill participants and proxies who reported low life satisfaction.

DISCUSSION

Results qualify theoretical expectations and empirical results based on self-report data that are typically available 1 or 2 years before death. We discuss that retrospective proxy reports in panel surveys can be used as a hypothesis-generating tool to gather insights into late life.

A systematic review of social factors and suicidal behavior in older adulthood

Suicide in later life is a global public health problem. The aim of this review was to conduct a systematic analysis of studies with comparison groups that examined the associations between social factors and suicidal behavior (including ideation, non-fatal suicidal behavior, or deaths) among individuals aged 65 and older. Our search identified only 16 articles (across 14 independent samples) that met inclusion criteria. The limited number of studies points to the need for further research. Included studies were conducted in Canada (n = 2), Germany (n = 1), Hong Kong (n = 1), Japan (n = 1), Singapore (n = 1), Sweden (n = 2), Taiwan (n = 1), the U.K. (n = 2), and the U.S. (n = 3). The majority of the social factors examined in this review can be conceptualized as indices of positive social connectedness-the degree of positive involvement with family, friends, and social groups. Findings indicated that at least in industrialized countries, limited social connectedness is associated with suicidal ideation, non-fatal suicidal behavior, and suicide in later life. Primary prevention programs designed to enhance social connections as well as a sense of community could potentially decrease suicide risk, especially among men.