Premorbid personality characteristics in Alzheimer's disease: an exploratory case-control study

Optimism and pessimism as predictors of seizure group among patients with intractable seizure disorders

The purpose of this study was to investigate the validity of the Revised Optimism-Pessimism Scale (PSM-R) as a measure of attributional style, and the incremental utility of optimism and pessimism as predictors of seizure group, in an intractable seizure disorder sample. Participants included adult patients with epileptic seizures (ES; n = 151) and psychogenic nonepileptic seizures (PNES; n = 173) whose diagnoses were confirmed by prolonged video/EEG monitoring (PVEM). Optimism and pessimism scores were computed from abbreviated versions of the MMPI for all participants. Analyses were conducted to examine the relationships between optimism, pessimism, and MMPI clinical scale scores. Logistic regression analyses were conducted to generate a model for the prediction of seizure group. Results supported the validity of the PSM-R as a measure of attributional style in an intractable seizure disorder sample. Both optimism and pessimism provided significant incremental predictive utility over and above other predictors of seizure group. There are advantages of using the proposed prediction model over other alternative differential diagnostic procedures, including lower cost, greater availability, and increased standardization. Overall, results indicated that attributional style is a clinically relevant index of personality and cognitive response to stress among an intractable seizure disorder sample.

Seligman's Theory of Attributional Style: Optimism, Pessimism, and Quality of Life after Heart Transplant

Context—

Posttransplant quality of life can be significantly affected by personality characteristics identified before transplant.

Objective—

Although overall quality of life in heart transplant patients improves after transplant, many studies reveal poorer mental health outcomes after transplant. We aimed to determine whether transplant recipients with an optimistic explanatory style had improved quality of life, fewer depressive symptoms, and increased survival.

Design—

We reviewed 68 patients who had completed a Minnesota Multiphasic Personality Inventory a mean of 2 years before transplant and examined associations between scores on the Optimism-Pessimism scale, survival rates, and results from the Health Status Questionnaire nearly 4 years after transplant.

Results—

Optimism was significantly associated with higher quality of life even after age (at the time of transplant), sex, depression score before transplant, time from the personality inventory to transplant, and time from transplant to the Health Status Questionnaire were controlled for. Furthermore, a pessimistic explanatory style was significantly associated with self-reported depressive symptoms, even after depression before transplant was adjusted for. Neither optimism nor pessimism was associated with length of survival.

Conclusions—

Pretransplant patients with a pessimistic explanatory style reported depressive symptoms nearly 5 years later. Furthermore, over the same time span, patients with an optimistic explanatory style described a significantly higher quality of life than the pessimists described.

Anxious personality predicts an increased risk of Parkinson's disease

We studied the association of three personality traits related to neuroticism with the subsequent risk of Parkinson's disease (PD) using a historical cohort study. We included 7,216 subjects who resided within the 120-mile radius centered in Rochester, MN, at the time they completed the Minnesota Multiphasic Personality Inventory (MMPI) for research at the Mayo Clinic from 1962 to 1965. We considered three MMPI personality scales (pessimistic, anxious, and depressive traits). A total of 6,822 subjects (94.5%) were followed over four decades either actively or passively. During follow-up, 227 subjects developed parkinsonism (156 developed PD). An anxious personality was associated with an increased risk of PD [hazard ratio (HR), 1.63; 95% confidence interval (CI), 1.16-2.27]. A pessimistic personality trait was also associated with an increased risk of PD but only in men (HR = 1.92; 95% CI = 1.20-3.07). By contrast, a depressive trait was not associated with increased risk. Analyses combining scores from the three personality scales into a composite neuroticism score showed an association of neuroticism with PD (HR = 1.54; 95% CI = 1.10-2.16). The association with neuroticism remained significant even when the MMPI was administered early in life (ages 20-39 years). By contrast, none of the three personality traits was associated with the risk of non-PD types of parkinsonism grouped together. Our long-term historical cohort study suggests that an anxious personality trait may predict an increased risk of PD developing many years later.

A pessimistic explanatory style is prognostic for poor lung cancer survival

BACKGROUND

Several studies have demonstrated the importance of personality constructs on health behaviors and health status. Having a pessimistic outlook has been related to negative health behaviors and higher mortality. However, the construct has not been well explored in cancer populations.

METHODS

Survival time of 534 adults who were diagnosed with lung cancer was examined. The patients had completed the Minnesota Multiphasic Personality Inventory approximately 18.2 years before receiving their lung cancer diagnosis. Minnesota Multiphasic Personality Inventory Optimism-Pessimism scores were divided into high (60 or more) and low scores (<60), and log-rank tests and Kaplan-Meier curves were used to determine survival differences. Multivariate Cox models were used for assessing prognostic values of pessimism along with other known predictors for lung cancer survival outcome. Bootstrapping of the survival models was used as a sensitivity analysis.

RESULTS

At the time of lung cancer diagnosis, patients were at an average age of 67 years old; 48% of them were women, 85% had non-small cell lung cancer, 15% had small cell lung cancer, 30% were stage I, 4% were stage II, 31% were stage III/limited, and 35% were stage IV/extensive. Patients who exhibited a nonpessimistic explanatory style survived approximately 6 months longer than patients classified as having a pessimistic explanatory style.

CONCLUSION

Among lung cancer patients, those having a pessimistic explanatory style experienced a less favorable survival outcome, which may be related to cancer treatment decisions. Further research in this area is warranted.

Pessimistic, anxious, and depressive personality traits predict all-cause mortality: the Mayo Clinic cohort study of personality and aging

OBJECTIVE

To study the association between several personality traits and all-cause mortality.

METHODS

We established a historical cohort of 7216 subjects who completed the Minnesota Multiphasic Personality Inventory (MMPI) for research at the Mayo Clinic from 1962 to 1965, and who resided within a 120-mile radius centered in Rochester, MN. A total of 7080 subjects (98.1%) were followed over four decades either actively (via a direct or proxy telephone interview) or passively (via review of medical records or by obtaining their death certificates). We examined the association of pessimistic, anxious, and depressive personality traits (as measured using MMPI scales) with all-cause mortality.

RESULTS

A total of 4634 subjects (65.5%) died during follow-up. Pessimistic, anxious, and depressive personality traits were associated with increased all-cause mortality in both men and women. In addition, we observed a linear trend of increasing risk from the first to the fourth quartile for all three scales. Results were similar in additional analyses considering the personality scores as continuous variables, in analyses combining the three personality traits into a composite neuroticism score, and in several sets of sensitivity analyses. These associations remained significant even when personality was measured early in life (ages 20-39 years).

CONCLUSIONS

Our findings suggest that personality traits related to neuroticism are associated with an increased risk of all-cause mortality even when they are measured early in life.

The Mayo Clinic cohort study of personality and aging: design and sampling, reliability and validity of instruments, and baseline description

We established a historical cohort of 7,216 subjects who completed the Minnesota Multiphasic Personality Inventory (MMPI) at the Mayo Clinic from 1962 through 1965 for research (not clinical indication), and who resided within a 120-mile radius centered in Rochester, Minnesota. We describe here the overall cohort design and sampling, we report results concerning reliability and validity, and we describe age and sex patterns at baseline for four MMPI scores of primary interest (depression, anxiety, social introversion, and negativity). Subjects excluded from the cohort because of missing data had MMPI scores similar to subjects included (after appropriate rescaling). A cut-off specific for age and sex at the 75th percentile of the distribution of raw scores was valid compared with the traditional clinical cut-off (T scores plus one standard deviation). Baseline scores for all four scales were higher in women than in men at all ages (all p < 0.0001). Depression and social introversion scores showed an increasing trend with age in both sexes (Spearman rank correlation, rho = 0.05 and 0.08, respectively, p < 0.0001 for both). Baseline scores on the anxiety scale showed a decreasing trend with age in both sexes (rho = -0.06, p < 0.0001). Negativity scores remained relatively stable with age in both sexes (rho = 0.03, p = 0.01). We found a high correlation between the anxiety score and the negativity score (rho = 0.90, p < 0.0001) even after the exclusion of overlapping items (rho = 0.68, p < 0.0001). This newly established historical cohort study provides opportunities to test hypotheses regarding the link between personality and aging, aging-related diseases, and overall mortality.

Optimism-pessimism assessed in the 1960s and self-reported health status 30 years later

OBJECTIVE

To study the association between explanatory style, using scores from the Optimism-Pessimism (PSM) scale of the Minnesota Multiphasic Personality Inventory (MMPI), and self-reported health status, using scores from the 36-Item Short-Form Health Survey (SF-36).

PATIENTS AND METHODS

A total of 447 patients who completed the MMPI between 1962 and 1965 as self-referred general medical outpatients and also completed the SF-36 thirty years later compose the current study sample. The associations between the scores on the SF-36 and the MMPI PSM scale were evaluated by analysis of variance and linear regression analysis.

RESULTS

Of 447 patients, 101 were classified as optimistic, 272 as mixed, and 74 as pessimistic. Scores on all 8 health concept domains from the SF-36 were significantly poorer in the pessimistic group than in both the optimistic and the mixed group.

CONCLUSION

A pessimistic explanatory style, reflected by higher PSM scale scores, was significantly associated with a self-report of poorer physical and mental functioning on the SF-36 30 years later.

A unifying hypothesis of Alzheimer's disease. III. Risk factors

Normal ageing and Alzheimer's disease (AD) have many features in common and, in many respects, both conditions only differ by quantitative criteria. A variety of genetic, medical and environmental factors modulate the ageing-related processes leading the brain into the devastation of AD. In accordance with the concept that AD is a metabolic disease, these risk factors deteriorate the homeostasis of the Ca(2+)-energy-redox triangle and disrupt the cerebral reserve capacity under metabolic stress. The major genetic risk factors (APP and presenilin mutations, Down's syndrome, apolipoprotein E4) are associated with a compromise of the homeostatic triangle. The pathophysiological processes leading to this vulnerability remain elusive at present, while mitochondrial mutations can be plausibly integrated into the metabolic scenario. The metabolic leitmotif is particularly evident with medical risk factors which are associated with an impaired cerebral perfusion, such as cerebrovascular diseases including stroke, cardiovascular diseases, hypo- and hypertension. Traumatic brain injury represents another example due to the persistent metabolic stress following the acute event. Thyroid diseases have detrimental sequela for cerebral metabolism as well. Furthermore, major depression and presumably chronic stress endanger susceptible brain areas mediated by a host of hormonal imbalances, particularly the HPA-axis dysregulation. Sociocultural and lifestyle factors like education, physical activity, diet and smoking may also modulate the individual risk affecting both reserve capacity and vulnerability. The pathophysiological relevance of trace metals, including aluminum and iron, is highly controversial; at any rate, they may adversely affect cellular defences, antioxidant competence in particular. The relative contribution of these factors, however, is as individual as the pattern of the factors. In familial AD, the genetic factors clearly drive the sequence of events. A strong interaction of fat metabolism and apoE polymorphism is suggested by intercultural epidemiological findings. In cultures, less plagued by the 'blessings' of the 'cafeteria diet-sedentary' Western lifestyle, apoE4 appears to be not a risk factor for AD. This intriguing evidence suggests that, analogous to cardiovascular diseases, apoE4 requires a hyperlipidaemic lifestyle to manifest as AD risk factor. Overall, the etiology of AD is a key paradigm for a gene-environment interaction. Copyright 2000 John Wiley & Sons, Ltd.