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Sasseville M, LeBlanc A, Tchuente J, Boucher M, Dugas M, Gisèle M, Barony R, Chouinard MC, Beaulieu M, Beaudet N, Skidmore B, Cholette P, Aspiros C, Larouche A, Chabot G, Gagnon MP. The impact of technology systems and level of support in digital mental health interventions: a secondary meta-analysis. Syst Rev 2023; 12:78. [PMID: 37143171 PMCID: PMC10157597 DOI: 10.1186/s13643-023-02241-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/20/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND The majority of people with a chronic disease (e.g., diabetes, hypertension, COPD) have more than one concurrent condition and are also at higher risk for developing comorbidities in mental health, including anxiety and depression. There is an urgent need for more relevant and accurate data on digital interventions in this area to prepare for an increase demand for mental health services. The aim of this study was to conduct a meta-analysis of the digital mental health interventions for people with comorbid physical and mental chronic diseases to compare the effect of technology systems and level of support. METHODS This secondary meta-analysis follows a rapid review of systematic reviews, a virtual workshop with knowledge users to identify research questions and a modified Delphi study to guide research methods: What types of digital health interventions (according to a recognized categorization) are the most effective for the management of concomitant mental health and chronic disease conditions in adults? We conducted a secondary analysis of the primary studies identified in the rapid review. Two reviewers independently screened the titles and abstracts and applied inclusion criteria: RCT design using a digital mental health intervention in a population of adults with another chronic condition, published after 2010 in French or English, and including an outcome measurement of anxiety or depression. RESULTS Seven hundred eight primary studies were extracted from the systematic reviews and 84 primary studies met the inclusion criteria Digital mental health interventions were significantly more effective than in-person care for both anxiety and depression outcomes. Online messaging was the most effective technology to improve anxiety and depression scores; however, all technology types were effective. Interventions partially supported by healthcare professionals were more effective than self-administered. CONCLUSIONS While our meta-analysis identifies digital intervention's characteristics are associated with better effectiveness, all technologies and levels of support could be used considering implementation context and population. TRIAL REGISTRATION The protocol for this review is registered in the National Collaborating Centre for Methods and Tools (NCCMT) COVID-19 Rapid Evidence Service (ID 75).
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Affiliation(s)
- Maxime Sasseville
- Université Laval-VITAM Research Center on Sustainable Health, Quebec City, Canada.
| | - Annie LeBlanc
- Université Laval-VITAM Research Center on Sustainable Health, Quebec City, Canada
| | - Jack Tchuente
- VITAM Research Center on Sustainable Health, Quebec City, Canada
| | | | - Michèle Dugas
- VITAM Research Center on Sustainable Health, Quebec City, Canada
| | | | | | | | | | - Nicolas Beaudet
- Université de Sherbrooke, Omnimed, Sherbrooke, Quebec, Canada
| | - Becky Skidmore
- Université Laval-VITAM Research Center on Sustainable Health, Quebec City, Canada
| | - Pascale Cholette
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale, Quebec City, Canada
| | - Christine Aspiros
- Université Laval-VITAM Research Center on Sustainable Health, Quebec City, Canada
| | - Alain Larouche
- Université Laval-VITAM Research Center on Sustainable Health, Quebec City, Canada
| | - Guylaine Chabot
- Université Laval-VITAM Research Center on Sustainable Health, Quebec City, Canada
| | - Marie-Pierre Gagnon
- Université Laval-VITAM Research Center on Sustainable Health, Quebec City, Canada
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Gong Z, Jiao X, Zhang M, Qu Q, Sun B. Effects of personal growth initiative on occupational engagement of college students in the uncertain social context: A cross-lagged model and a moderated mediation model. Front Psychol 2022; 13:988737. [PMID: 36211915 PMCID: PMC9533056 DOI: 10.3389/fpsyg.2022.988737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/07/2022] [Indexed: 12/05/2022] Open
Abstract
In recent years, the international social context has become increasingly volatile, uncertain, complex, ambiguous (VUCA), and college students need a high level of long-term occupational engagement to cope with the unpredictability of the current employment environment. In this context, this study used a longitudinal design to explore the relationship between personal growth initiative and occupational engagement among college students and, based on this, further explored the role of vocational identity and Big Five personality traits in it. This study used a questionnaire survey method and the study participants were 700 college students in Shandong, China. And the time interval between the two questionnaire measurements was 4 months, with 559 final valid participants (182 males and 377 females). The following results were found in this study: (1) The cross-lagged model found that personal growth initiative was a significant positive predictor of occupational engagement. (2) The moderated mediation model found that vocational identity mediated the relationship between personal growth initiative and occupational engagement, and that neuroticism among the Big Five personality traits played a moderating role, i.e., individuals with higher level of neuroticism personality trait had a relatively weaker positive predictive effect of vocational identity on occupational engagement. This study concludes that colleges and universities need to understand students' interests and personality traits and provide more targeted career education (e.g., intentional growth training and cognitive behavioral therapy) to promote their personal growth initiatives, reduce their neuroticism levels and in turn enhance their vocational identity in order to help college students achieve long-term sustainable occupational engagement in the uncertain social context.
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Affiliation(s)
- Zhun Gong
- Normal College, Qingdao University, Qingdao, China
| | - Xinian Jiao
- Normal College, Qingdao University, Qingdao, China
| | | | - Qunzhen Qu
- School of Economics and Management, Shanghai Maritime University, Shanghai, China
| | - Baicai Sun
- Normal College, Qingdao University, Qingdao, China
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Fagerberg T, Söderman E, Gustavsson JP, Agartz I, Jönsson EG. Thirteen-year follow-up of long-term treated psychotic disorder: personality aspects. Nord J Psychiatry 2022; 76:386-393. [PMID: 34620037 DOI: 10.1080/08039488.2021.1981436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Personality is an aspect that can affect the symptoms and social function in individuals with psychotic disorders. Several studies have investigated personality in schizophrenia and other long-term psychotic disorders. No study has examined the stability of personality traits exceeding five years in patients with schizophrenia and related disorders. The aim of this study was to investigate the stability of personality traits over a 13-year period among patients with schizophrenia and related disorders and healthy individuals and to evaluate case-control differences. METHODS At three occasions during a 13-year period patients with schizophrenia and related disorders (n = 28) and healthy individuals (n = 57) completed Swedish universities Scales of Personality (SSP). Mean-level change and case-control differences were investigated for all the individuals using within- and between-subject analyses, respectively. Analyses were performed on three occasions for all 13 subscales and the three overall factors of SSP. Also, correlations, means, and SDs were calculated. RESULTS Tests of within-subject correlations showed differences in two subscales: Lack of Assertiveness, which were influenced by age, and Physical Trait Aggression, where patients' ratings were stable, whereas controls rated themselves less aggressive at a higher age. Between-subjects correlations showed differences regarding diagnosis, time, age, gender, or age × gender in nine of the 13 subscales as well as in factor Neuroticism. CONCLUSION Long-term follow-up showed generally high stability of personality traits measured with SSP. Between-subject analyses over the 13 years showed that patients differed compared to controls for the SSP factor Neuroticism as well as the subscale Detachment, which is in accordance with previous studies within this population.
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Affiliation(s)
- Tomas Fagerberg
- Human Brain Informatics (HUBIN), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Erik Söderman
- Human Brain Informatics (HUBIN), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - J Petter Gustavsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Agartz
- Human Brain Informatics (HUBIN), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden.,NORMENT - TOP study, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Erik G Jönsson
- Human Brain Informatics (HUBIN), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden.,NORMENT - TOP study, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Bayat A, Amiri-Farahani L, Soleimani M, Eshraghi N, Haghani S. Effect of short-term psychological intervention on anxiety of pregnant women with positive screening results for chromosomal disorders: a randomized controlled trial. BMC Pregnancy Childbirth 2021; 21:757. [PMID: 34753431 PMCID: PMC8576873 DOI: 10.1186/s12884-021-04206-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/18/2021] [Indexed: 11/24/2022] Open
Abstract
Background and aim Prenatal diagnosis of fetal abnormalities is a critical and stressful event for women. Most pregnant women are concerned about fetal abnormalities and screening tests. Due to the importance of anxiety reduction in pregnant women, this study was conducted to determine the effect of short-term psychological intervention on the anxiety of pregnant women with positive screening results for chromosomal disorders. Methods A randomized clinical trial was performed on women referred to Akbarabadi Hospital in Tehran, Iran, who had positive screening results for chromosomal abnormalities. Participants were selected from eligible individuals by a continuous method and were assigned to two groups of cognitive-behavioral training (n = 46) and control (n = 46), using the block balanced randomization method. Participants in the cognitive-behavioral training group received 4 sessions of individual counseling. The control group received routine pregnancy visits. The Spielberger State-Trait Anxiety Inventory was completed before the intervention and immediately at the end of the intervention (before receiving the amniocentesis result). The analysis of intervention effects was performed as intention-to-treat and per-protocol analysis. Results There was a statistically significant difference in post-intervention state anxiety scores and trait anxiety scores (p < 0.001) between the intervention and control groups, when their means were adjusted for pre-intervention scores for both intention-to-treat and per-protocol analysis. Also, there was a large effect size between the groups in terms of state (ITT: ηp2 = 0.63, PP: ηp2 = 0.71) and trait (ITT: ηp2 = 0.72, PP: ηp2 = 0.75) anxiety scores clinically for both intention-to-treat and per-protocol analysis. The intervention group had a statistically significant and large decrease in state and trait anxiety scores from pretrial to post-trial. In contrast, the control group had a statistically significant and medium increase in state and trait anxiety scores from pretrial to post-trial. Conclusion The results showed that cognitive-behavioral training reduced the anxiety of pregnant women with positive screening results for chromosomal disorders. According to the results, it is recommended to hold cognitive-behavioral training classes to reduce the anxiety of pregnant women with a positive screening result for chromosomal disorders. Trial registration IRCT.ir: IRCT20180427039436N7; date of registration: 24/08/2020 2020-08-24. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04206-5.
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Affiliation(s)
- Arezoo Bayat
- Department of Reproductive Health and Midwifery, Shahid Akbarabadi Clinical Research Development Unit (Sh ACRDU), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Amiri-Farahani
- Department of Reproductive Health and Midwifery, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, 1996713883, Iran.
| | - Mehdi Soleimani
- Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nooshin Eshraghi
- Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Akbarabadi Teaching Hospital, Tehran, Iran
| | - Shima Haghani
- Department of Biostatistics, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
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Tyrer P, Wang D, Tyrer H, Crawford M, Loebenberg G, Cooper S, Barrett B, Sanatinia R. Influence of apparently negative personality characteristics on the long-term outcome of health anxiety: Secondary analysis of a randomized controlled trial. Personal Ment Health 2021; 15:72-86. [PMID: 32985777 DOI: 10.1002/pmh.1496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/27/2020] [Accepted: 09/02/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND It is known that personality has an influence on the outcome of mental state disorders, but detailed studies on its long-term impact are few. We examined the influence of personality status on the 8-year outcome of health anxiety and its relationship to the effects of cognitive behaviour therapy in a randomized controlled trial. AIMS This study aims to examine both the usefulness of the diagnosis of personality disorder and an additional measure of pathological dependence, in predicting the outcome of medical patients with health anxiety treated with cognitive behaviour therapy. Because the influence of personality is often shown in the long term, these assessments covered the period of 8 years after randomization. An additional aim is to examine the costs of different levels of personality dysfunction in each treatment group. METHOD Personality dysfunction, using both ICD-10 and ICD-11 classifications of severity, was assessed at baseline by interview in a randomized controlled trial. Patients were also assessed for pathological dependence using the Dependent Personality Questionnaire, also scored along a severity dimension. Four hundred forty-four patients from medical clinics with pathological health anxiety were treated with a modified form of cognitive behaviour therapy for health anxiety (CBT-HA) or standard care. Total costs over follow-up were calculated from hospital data and compared by personality group. RESULTS At baseline, 381 (86%) had some personality dysfunction, mainly at the lower level of personality difficulty (not formally a disorder). One hundred eighty four (41%) had a personality disorder. A similar proportion was found with regard to dependent personality. Using the ICD-10 classification, 153 patients (34.6%) had a personality disorder, with 83 (54.2%) having anxious or dependent personality disorder, 20 (13.1%) having an anankastic disorder, but also with 66 (43.1%) having mixed disorder. During initial treatment, those with personality disorder adhered more closely to CBT-HA, and after 8 years, they had a significantly better outcome than those with personality difficulty and no personality disorder (p < 0.002). Similar results were found in those scoring high on the Dependent Personality Questionnaire. All these differences increased over the follow-up period. Costs were similar in all groups but were somewhat higher in the CBT-HA one; this finding is hypothesised to be due to fuller hospital treatment once health anxiety is discounted. CONCLUSION Personality disorder in people with health anxiety, particularly in those who have anxious and dependent traits, reinforces the benefits of cognitive behaviour therapy, particularly in the longer term. © 2020 The Authors Personality and Mental Health Published by John Wiley & Sons Ltd.
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Affiliation(s)
- Peter Tyrer
- Centre for Mental Health, Imperial College, London, UK
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Helen Tyrer
- Centre for Mental Health, Imperial College, London, UK
| | - Mike Crawford
- Centre for Mental Health, Imperial College, London, UK
| | - Gemma Loebenberg
- North West London Clinical Research Network, Hammersmith Hospital, London, UK
| | - Sylvia Cooper
- Centre for Mental Health, Imperial College, London, UK
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Robins TG, Roberts RM, Sarris A. Understanding How Personality Impacts Exhaustion and Engagement: The Role of Job Demands, and Job and Personal Resources as Mediators. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12310] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Aspa Sarris
- School of Psychology, The University of Adelaide,
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Sauer-Zavala S, Southward MW, Semcho SA. Integrating and differentiating personality and psychopathology in cognitive behavioral therapy. J Pers 2020; 90:89-102. [PMID: 33070346 DOI: 10.1111/jopy.12602] [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] [Received: 10/01/2020] [Accepted: 10/09/2020] [Indexed: 12/23/2022]
Abstract
A large body of literature supports the strong association between personality features and psychopathology. This research has, however, had little influence on day-to-day therapeutic practice, particularly in cognitive behavioral approaches that have traditionally focused on addressing the symptoms of categorically defined diagnoses. Indeed, there are few CBT protocols aimed at altering the personality features. Recently, however, the CBT literature has displayed an increased focus on identifying alternative higher-order, dimensional mechanisms that may underscore the development and maintenance of broad classes of psychopathology (e.g., aversive reactivity to emotions, reward sensitivity, and performance expectancies). There is ample evidence linking these processes to DSM disorder severity; however, they may also represent a functional link between the personality domains and the disorder symptoms organized beneath them. The functional mechanisms through which an individual's personality confers risk for psychopathology may be naturally amenable to cognitive behavioral elements, and targeting these processes in treatment has the potential to address both disorder symptoms and underlying personality vulnerabilities. Thus, the identification of intermediate functional mechanisms may help bridge the gap between personality science and clinical practice.
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Affiliation(s)
| | | | - Stephen A Semcho
- Department of Psychology, University of Kentucky, Lexington, KY, USA
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8
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Lee SA, Crunk EA. Fear and Psychopathology During the COVID-19 Crisis: Neuroticism, Hypochondriasis, Reassurance-Seeking, and Coronaphobia as Fear Factors. OMEGA-JOURNAL OF DEATH AND DYING 2020; 85:483-496. [PMID: 32762291 DOI: 10.1177/0030222820949350] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic has generated a rise in psychological distress worldwide. Although fear appears to be a major contributing factor, there has been no systematic research to determine which specific facets of fear predict psychopathology during the coronavirus crisis. The present study is the first to examine which fear factors uniquely predict clinical levels of depressive symptoms and generalized anxiety. Data were collected from 256 adults in the United States recruited from Amazon's Mechanical Turk (MTurk) during the coronavirus pandemic. The results from logistic regression analyses demonstrated that neuroticism, coronaphobia, and hypochondriasis were fear factors that predicted pandemic-related psychopathology in adults. These findings suggest that mental health professionals should screen individuals for this set of fear factors when choosing appropriate assessments and interventions for treating people who are suffering during the crisis.
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Affiliation(s)
- Sherman A Lee
- Department of Psychology, Christopher Newport University, Newport News, Virginia, United States
| | - Elizabeth A Crunk
- Counseling and Human Development, The George Washington University, Washington DC, United States
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Lee SA, Jobe MC, Mathis AA, Gibbons JA. Incremental validity of coronaphobia: Coronavirus anxiety explains depression, generalized anxiety, and death anxiety. J Anxiety Disord 2020; 74:102268. [PMID: 32650221 PMCID: PMC7328548 DOI: 10.1016/j.janxdis.2020.102268] [Citation(s) in RCA: 175] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 12/15/2022]
Abstract
The adverse psychological effects of COVID-19 have increased globally. Moreover, the psychological toll may be worsening for this health crisis due to the growing numbers of mass deaths and unemployment levels. Coronaphobia, a relatively new pandemic-related construct, has been shown to be strongly related to functional impairment and psychological distress. However, the extent to which coronaphobia is uniquely accountable for the psychological distress experienced during the COVID-19 crisis has not been systematically investigated. The current study examined this question of incremental validity using online data from 453 adult MTurk workers in the U.S. The results of a series of hierarchical multiple regression analyses demonstrated that coronaphobia explained additional variance in depression, generalized anxiety, and death anxiety, above sociodemographics, COVID-19 factors, and the vulnerability factors of neuroticism, health anxiety, and reassurance-seeking behaviors. These findings suggest that health professionals should be aware of coronaphobia as this expression of pandemic-related stress has reliably demonstrated incremental validity in accounting for major indicators of psychological distress.
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Affiliation(s)
- Sherman A. Lee
- Corresponding author at: Department of Psychology, Christopher Newport University, 1 Avenue of the Arts, Newport News, VA, 23606, United States.
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Tóth-Vajna G, Tóth-Vajna Z, Balog P, Konkolÿ Thege B. Depressive symptomatology and personality traits in patients with symptomatic and asymptomatic peripheral arterial disease. BMC Cardiovasc Disord 2020; 20:304. [PMID: 32571227 PMCID: PMC7310261 DOI: 10.1186/s12872-020-01586-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 06/15/2020] [Indexed: 01/22/2023] Open
Abstract
Background The aim of this study was to examine the relationship of depressive symptomatology and personality traits with peripheral arterial disease (PAD). Methods The sample of this cross-sectional study comprised of 300 individuals (Mage = 65.3 ± 8.7 years, 61.0% female) recruited from the offices of 33 general practitioners. Based on at-rest ankle-brachial index (ABI) values and claudication symptoms, four subsamples were formed: clear PAD-positive, clear PAD-negative, ABI-negative but symptomatic, and a non-compressible-artery group. The concurrent role of depression (assessed by a shortened version of the Beck Depression Inventory) and personality traits (measured by the Big Five Inventory) in predicting PAD status was examined using multinomial logistic regression – controlled for sex, age, hypertonia, diabetes, smoking, hazardous drinking, and body mass index. Results Depressive symptomatology was significant in predicting peripheral arterial disease status even after controlling for both traditional risk factors and personality traits. Among the Big Five personality traits, neuroticism showed a significant, positive relationship with PAD – independently of depression. Conclusions Patients with PAD – even those with asymptomatic forms of the disease – are at higher risk for suffering from depression compared to individuals without PAD, independently of neuroticism, other Big Five personality dimensions or traditional risk factors for cardiovascular diseases.
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Affiliation(s)
- Gergely Tóth-Vajna
- Institute of Behavioral Sciences, Semmelweis University, Nagyvárad tér 4. XX. emelet, Budapest, 1089, Hungary.
| | - Zsombor Tóth-Vajna
- Heart and Vascular Center, Department of Vascular Surgery, Semmelweis University, Városmajor utca 68, Budapest, 1122, Hungary
| | - Piroska Balog
- Institute of Behavioral Sciences, Semmelweis University, Nagyvárad tér 4. XX. emelet, Budapest, 1089, Hungary.
| | - Barna Konkolÿ Thege
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, 500 Church St, Penetanguishene, Ontario, Canada.,Department of Psychiatry, University of Toronto, 250 College St, Toronto, Ontario, Canada
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Spangenberg H, Ramklint M, Ramirez A. Long-term stability of personality traits in a clinical psychiatric sample. Nord J Psychiatry 2019; 73:309-316. [PMID: 31304872 DOI: 10.1080/08039488.2019.1623316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: The aim of this study was to describe personality traits in psychiatric patients and to investigate whether these traits are stable over 13 years. Methods: A total of 95 individuals who were patients at a psychiatric outpatients' clinic in 2003 completed the Swedish universities Scales of Personality (SSP). Scores from 2003 were compared with SSP scores from 2016. Based on the current score on the comprehensive psychopathological rating scale - self rating for affective disorders (CPRS-S-A), the participants were divided into two groups representing 'good' and 'poor' current mental states, to investigate the effect of current mental state on reports of personality traits. Results: Out of 13 personality traits, 11 showed a significant change in mean T-score over the study interval. The group with lower CPRS-S-A scores showed a significant change in T-score for 10 traits, whereas in the group with higher CPRS-S-A scores only 3 traits showed a significant change. Conclusions: The findings support the theory that personality is changeable over the course of life, also in psychiatric patients. We do not know if persisting psychiatric symptoms halter change or if deviant personality traits cause psychiatric symptoms to continue.
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Affiliation(s)
- Hanna Spangenberg
- a Department of Neuroscience, Akademiska sjukhuset, Uppsala University , Uppsala , Sweden
| | - Mia Ramklint
- a Department of Neuroscience, Akademiska sjukhuset, Uppsala University , Uppsala , Sweden
| | - Adriana Ramirez
- a Department of Neuroscience, Akademiska sjukhuset, Uppsala University , Uppsala , Sweden
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Personality Traits Predict Meeting the WHO Recommendation of 6 Months' Breastfeeding: A Prospective General Population Cohort Study. Adv Neonatal Care 2019; 19:118-126. [PMID: 30325749 DOI: 10.1097/anc.0000000000000547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although personality as well as anxiety and depression are recognized as predictors for breastfeeding initiation, evidence of an association of these factors with 6 months' exclusive breastfeeding as recommended by the World Health Organization (WHO) is sparse. PURPOSE The purpose of this study was to investigate the associations of personality and symptoms of anxiety and depression during and after pregnancy with meeting the WHO recommendation of 6 months' exclusive breastfeeding. METHODS In their first trimester of pregnancy, 5784 pregnant women were enrolled in Dutch primary obstetric care centers and hospitals, of which 2927 completed the breastfeeding assessments 6 months postpartum. We performed logistic regression analyses to test the associations of "big five" personality traits (NEO Five Factor Inventory), anxiety (State-Trait Anxiety Inventory), and depression (Edinburgh Postnatal Depression Scale) symptom levels during pregnancy and postpartum with meeting the WHO recommendation of 6 months' exclusive breastfeeding. RESULTS Agreeableness (odds ratio [OR] = 1.18, P = .006) and openness (OR = 1.31, P < .001) were positively associated with meeting the WHO recommendation, whereas extraversion (OR = 0.83, P = .005) and neuroticism (OR = 1.18, P = .006) were negatively associated. After adjustment for both antenatal and postpartum symptom levels of anxiety and depression, the associations of the agreeableness, extraversion, and openness personality traits remained strong and statistically significant (P < .05). IMPLICATIONS FOR PRACTICE Patient-centered care should take personality into account in an effort to tailor interventions to optimize breastfeeding behavior. IMPLICATIONS FOR RESEARCH In contrast to earlier findings, personality traits may be of greater importance than symptoms of anxiety and depression for meeting the WHO recommendation of 6 months' exclusive breastfeeding.
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Lonely But Not Alone: Neuroticism Mediates the Relationship Between Social Network Size and Loneliness in Individuals With Traumatic Brain Injury. J Int Neuropsychol Soc 2019; 25:285-292. [PMID: 30567616 DOI: 10.1017/s1355617718001108] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objectives: Although individuals with traumatic brain injury (TBI) often report higher levels of social isolation, little is known about the factors influencing their self-perception of loneliness. The aim of the current study was to investigate the relationship between loneliness, social network size, and personality variables (neuroticism and extraversion) after TBI, and in particular whether specific personality variables mediate the relationship between social network size and perception of loneliness. Methods: Here, we assessed self-reported loneliness, personality variables, and social network size of 24 individuals with moderate-to-severe TBI and 41 healthy comparison participants. We then carried out a mediation analysis to examine whether personality variables mediated the relationship between loneliness and social network size. Results: Our results indicate that individuals with TBI reported higher levels of loneliness and neuroticism, but there was no group difference in social network size or extraversion. The mediation analysis revealed that the association between social network size and loneliness was mediated by neuroticism, but not by extraversion. Conclusions: Our findings show that neuroticism is an intervening variable in the relationship between social network size and self-perception of loneliness in individuals with moderate-to-severe TBI, and presents a new possible target for clinicians and rehabilitators seeking to address reports of loneliness and social isolation in TBI. (JINS 2019, 25, 266-274).
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Axfors C, Hellgren C, Volgsten H, Skoog Svanberg A, Ekselius L, Wikström AK, Ramklint M, Skalkidou A, Sundström-Poromaa I. Neuroticism is associated with higher antenatal care utilization in obstetric low-risk women. Acta Obstet Gynecol Scand 2018; 98:470-478. [PMID: 30457176 DOI: 10.1111/aogs.13506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 11/13/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Elevated neuroticism is associated with higher health care utilization in the general population. This study aimed to investigate the association between neuroticism and the use of publicly financed antenatal care in obstetric low-risk women, taking predisposing and need factors for health care utilization into consideration. MATERIAL AND METHODS Participants comprised 1052 obstetric low-risk women (no chronic diseases or adverse pregnancy conditions) included in several obstetrics/gynecology studies in Uppsala, Sweden. Neuroticism was self-rated on the Swedish universities Scales of Personality. Medical records of their first subsequent pregnancy were scanned for antenatal care use. Associations between antenatal care use and neuroticism were analyzed with logistic regression (binary outcomes) or negative binomial regression (count outcomes) comparing the 75th and 25th neuroticism percentiles. Depending on the Akaike information criterion the exposure was modeled as either linear or with restricted cubic splines. Analyses were adjusted for predisposing (sociodemographic and parity) and need factors (body mass index and psychiatric morbidity). RESULTS After adjustment, women with higher neuroticism had more fetal ultrasounds (incidence rate ratio = 1.09, 95% confidence interval (CI) 1.02-1.16), more emergency visits to an obstetrician/gynecologist (incidence rate ratio = 1.22, 95% CI 1.03-1.45) and were more likely to visit a fear-of-childbirth clinic (odds ratio = 2.71, 95% CI 1.71-4.29). Moreover, they more often consulted midwives in specialized antenatal care facilities (significant J-shaped association). CONCLUSIONS Neuroticism was associated with higher utilization of publicly financed antenatal care in obstetric low-risk women, even after adjusting for predisposing and need factors. Future studies should address the benefits of interventions as a complement to routine antenatal care programs to reduce subclinical anxiety.
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Affiliation(s)
- Cathrine Axfors
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Charlotte Hellgren
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Helena Volgsten
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Lisa Ekselius
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Anna-Karin Wikström
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Mia Ramklint
- Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Alkistis Skalkidou
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Abstract
PURPOSE OF REVIEW We reviewed research on computer-assisted cognitive-behavior therapy (CCBT) performed in medical settings with the goals of assessing the effectiveness of this newer method of treatment delivery, evaluating the need for clinician support of therapeutic computer programs, and making suggestions for future research and clinical implementation. RECENT FINDINGS The overall results of randomized, controlled trials suggest that CCBT can be an effective treatment for depression in primary care patients and health care anxiety. Also, it can be a useful component of treatment for somatic conditions including irritable bowel syndrome, diabetes, fibromyalgia, and chronic pain. The amount and type of clinician support needed for maximizing effectiveness remains unclear. CCBT offers promise for overcoming barriers to delivering effective psychotherapy in medical settings. We recommend that next steps for researchers include more definitive studies of the influence of clinician support, investigations focused on implementation in clinical practices, cost-benefit analyses, and use of technological advances.
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Saleh D, Camart N, Sbeira F, Romo L. Can we learn to manage stress? A randomized controlled trial carried out on university students. PLoS One 2018; 13:e0200997. [PMID: 30183710 PMCID: PMC6124718 DOI: 10.1371/journal.pone.0200997] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/03/2018] [Indexed: 12/02/2022] Open
Abstract
In our research, we examined the efficacy of an Internet-based stress management program. Our interest in evaluating this type of intervention is based on the increasing accessibility of the Internet today, the growth of Internet-based interventions for various psychopathological problems, and the observation that despite the prevalence of stress among university students, only a fraction of students ever seek professional help. Methodology: “I’m managing my stress” (“Je gère mon stresse”), an Internet-based self-help program composed of four sessions, was examined in this study. The aforementioned program is based on cognitive-behavioral therapy and was inspired by the “Funambule” program in Quebec. Four questionnaires (Perceived Stress Scale, Rosenberg Self-Esteem Scale, Scale of Satisfaction in Studies, and General Health Questionnaire) uploaded online were answered thrice: during “preintervention”, “postintervention”, and “follow-up” stages, the latter of which occurred three months after the intervention. The sample comprised 128 university students, with the majority being women (81.25%). The subjects were divided randomly into two groups (an experimental group and a control group that did not follow the program). Results: The self-esteem scores of the control group were significantly higher than those of the experimental group at the preintervention stage, but this difference disappeared at the postintervention and follow-up stages. There were also significantly lower scores on the General Health Questionnaire subfactors of somatic symptoms and anxiety/insomnia in the experimental group than in the control group during the postintervention stage, though no differences were observed before the intervention. These differences no longer remained after three months. ANOVA revealed significant effects of the intervention over time in the experimental group. Effects were observed at both the postintervention and follow-up stages for self-esteem, perceived stress, satisfaction in studies, and in the somatic symptoms, anxiety and insomnia and severe depression aspects of the General Health Questionnaire (Cohen’s d = 0.38 to 4.58). In contrast, no effects were observed in the control group. Conclusion: This type of Internet-based program has the ability to reach a large number of students due to its rather short format and accessibility. It has already shown improvements in terms of the levels of perceived stress, psychological distress and satisfaction with studies. The option of online interventions could appeal specifically to students who do not seek professional help. However, even though these results are promising at the postintervention stage, they are limited, as indicated by the lack of significant differences between the two groups after the initial three months of follow-up. We still, specifically, need to improve this intervention program and, generally, need more research to address the methodological problems raised by this type of intervention. Trial registration: ISRCTN registry, ISRCTN13709272
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Affiliation(s)
- Dalia Saleh
- EA4430 CLIPSYD, UFR SPSE, Paris Nanterre University, Nanterre, France
- Counseling Psychology, Tishreen University, Latakia, Syria
- * E-mail:
| | - Nathalie Camart
- EA4430 CLIPSYD, UFR SPSE, Paris Nanterre University, Nanterre, France
| | - Fouad Sbeira
- Counseling Psychology, Tishreen University, Latakia, Syria
| | - Lucia Romo
- EA4430 CLIPSYD, UFR SPSE, Paris Nanterre University, Nanterre, France
- CMME, Centre Hospitalier Sainte Anne, Unité Inserm U864, CPN, Paris, France
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Abstract
PURPOSE OF REVIEW To examine the diagnosis of health anxiety, its prevalence in different settings, public health significance, treatment, and outcome. RECENT FINDINGS Health anxiety is similar to hypochondriasis but is characterized by fear of, rather than conviction of, illness. Lifetime prevalence rates are 6% in the population and as high as 20% in hospital out-patients, leading to greater costs to health services through unnecessary medical contacts. Its prevalence may be increasing because of excessive internet browsing (cyberchondria). Drug treatment with antidepressants has some efficacy but is not well-liked, but psychological treatments, including cognitive behavior therapy, stress management, mindfulness training, and acceptance and commitment therapy, given either individually, in groups, or over the Internet, have all proved efficacious in both the short and longer term. Untreated health anxiety leads to premature mortality. Health anxiety has become an increasing clinical and public health issue at a time when people are being formally asked to take more responsibility in monitoring their own health. More attention by health services is needed.
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Facilitating the Dissemination of iCBT for the Treatment of Anxiety and Depression: A Feasibility Study. BEHAVIOUR CHANGE 2018. [DOI: 10.1017/bec.2018.14] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
AbstractTranslating existing internet-based cognitive-behavioural therapy (iCBT), along with the use of transdiagnostic and self-guided formats, may prove to be a cost-effective option of disseminating iCBT. Only recently have encouraging findings been reported for a self-guided delivery. This study assessed the feasibility of a French and self-guided version of an existing English iCBT course, called the Wellbeing Course, for the treatment of anxiety and depression. Existing ICBT programs have not yet been delivered in French, although this language is spoken worldwide. Thirty-one participants were included in a single group pre-post open trial with a 3-month follow-up. Feasibility outcomes were attrition, treatment adherence, acceptability, and preliminary efficacy. Primary outcome measures were the Patient Health Questionnaire 9-item (PHQ-9) and the Generalised Anxiety Disorder 7-item (GAD-7). Nearly 75% of the participants completed the program. Over 80% of the participants provided posttreatment and follow-up data. All study completers reported that they would recommend the Wellbeing Course to a friend having similar problems. Significant reductions in symptoms of anxiety and depression were found following treatment, consistent with earlier studies. These preliminary findings support the use of the assessed strategies to facilitate the cross-cultural dissemination of iCBT for a more universal access to quality psychological care.
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Fagerberg T, Söderman E, Petter Gustavsson J, Agartz I, Jönsson EG. Stability of personality traits over a five-year period in Swedish patients with schizophrenia spectrum disorder and non-psychotic individuals: a study using the Swedish universities scales of personality. BMC Psychiatry 2018; 18:54. [PMID: 29486736 PMCID: PMC6389041 DOI: 10.1186/s12888-018-1617-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 01/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Personality is considered as an important aspect in persons with psychotic disorders. Several studies have investigated personality in schizophrenia. However, no study has investigated stability of personality traits exceeding three years in patients with schizophrenia. This study aims to investigate the stability of personality traits over a five-year period among patients with schizophrenia and non-psychotic individuals and to evaluate case-control differences. METHODS Patients with psychotic disorders (n = 36) and non-psychotic individuals (n = 76) completed Swedish universities Scales of Personality (SSP) at two occasions five years apart. SSP scores were analysed for effect of time and case-control differences by multiple analysis of covariance (MANCOVA) and within-subjects correlation. RESULTS MANCOVA within-subjects analysis did not show any effect of time. Thus, SSP mean scale scores did not significantly vary during the five-year interval. Within subject correlations (Spearman) ranged 0.30-0.68 and 0.54-0.75 for the different SSP scales in patients and controls, respectively. Patients scored higher than controls in SSP scales Somatic Trait Anxiety, Psychic Trait Anxiety, Stress Susceptibility, Lack of Assertiveness, Detachment, Embitterment, and Mistrust. CONCLUSION The stability of the SSP personality trait was reasonably high among patients with psychotic disorder, although lower than among non-psychotic individuals, which is in accordance with previous research.
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Affiliation(s)
- Tomas Fagerberg
- Human Brain Informatics (HUBIN), Department of Clinical Neuroscience, Centre for Psychiatric Research, Psychiatry Section, Karolinska Institutet and Hospital, Stockholm, Sweden.
| | - Erik Söderman
- 0000 0004 1937 0626grid.4714.6Human Brain Informatics (HUBIN), Department of Clinical Neuroscience, Centre for Psychiatric Research, Psychiatry Section, Karolinska Institutet and Hospital, Stockholm, Sweden
| | - J. Petter Gustavsson
- 0000 0004 1937 0626grid.4714.6Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Agartz
- 0000 0004 1937 0626grid.4714.6Human Brain Informatics (HUBIN), Department of Clinical Neuroscience, Centre for Psychiatric Research, Psychiatry Section, Karolinska Institutet and Hospital, Stockholm, Sweden ,NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine. Psychiatry section, University of Oslo, Oslo, Norway ,0000 0004 0512 8628grid.413684.cDepartment of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Erik G. Jönsson
- 0000 0004 1937 0626grid.4714.6Human Brain Informatics (HUBIN), Department of Clinical Neuroscience, Centre for Psychiatric Research, Psychiatry Section, Karolinska Institutet and Hospital, Stockholm, Sweden ,NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine. Psychiatry section, University of Oslo, Oslo, Norway
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20
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Võhma Ü, Raag M, Tõru I, Aluoja A, Maron E. Association between personality traits and Escitalopram treatment efficacy in panic disorder. Nord J Psychiatry 2017; 71:433-440. [PMID: 28472591 DOI: 10.1080/08039488.2017.1316772] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND There is strong evidence to suggest that personality factors may interact with the development and clinical expression of panic disorder (PD). A greater understanding of these relationships may have important implications for clinical practice and implications for searching reliable predictors of treatment outcome. AIMS The study aimed to examine the effect of escitalopram treatment on personality traits in PD patients, and to identify whether the treatment outcome could be predicted by any personality trait. METHOD A study sample consisting of 110 outpatients with PD treated with 10-20 mg/day of escitalopram for 12 weeks. The personality traits were evaluated before and after 12 weeks of medication by using the Swedish universities Scales of Personality (SSP). RESULTS Although almost all personality traits on the SSP measurement were improved after 12 weeks of medication in comparison with the baseline scores, none of these changes reached a statistically significant level. Only higher impulsivity at baseline SSP predicted non-remission to 12-weeks treatment with escitalopram; however, this association did not withstand the Bonferroni correction in multiple comparisons. LIMITATIONS All patients were treated in a naturalistic way using an open-label drug, so placebo responses cannot be excluded. The sample size can still be considered not large enough to reveal statistically significant findings. CONCLUSIONS Maladaptive personality disposition in patients with PD seems to have a trait character and shows little trend toward normalization after 12-weeks treatment with the antidepressant, while the association between impulsivity and treatment response needs further investigation.
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Affiliation(s)
- Ülle Võhma
- a North Estonia Medical Centre Foundation, Psychiatry Clinic , Tallinn , Estonia
| | - Mait Raag
- b Department of Public Health , University of Tartu , Tartu , Estonia
| | - Innar Tõru
- c Department of Psychiatry , University of Tartu , Tartu , Estonia
| | - Anu Aluoja
- c Department of Psychiatry , University of Tartu , Tartu , Estonia
| | - Eduard Maron
- a North Estonia Medical Centre Foundation, Psychiatry Clinic , Tallinn , Estonia.,c Department of Psychiatry , University of Tartu , Tartu , Estonia.,d Centre for Neuropsychopharmacology, Imperial College London , London , UK
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Almas A, Moller J, Iqbal R, Forsell Y. Effect of neuroticism on risk of cardiovascular disease in depressed persons - a Swedish population-based cohort study. BMC Cardiovasc Disord 2017; 17:185. [PMID: 28697763 PMCID: PMC5504725 DOI: 10.1186/s12872-017-0604-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 06/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The relationship between neuroticism, depression and cardiovascular disease (CVD) is complex and has so far not been studied in depth. The aim of this study was to determine if neuroticism is an effect-modifier in the association between depression and CVD. Data derived from a longitudinal cohort study on mental health, work and relations among adults (20-64 years), including 10,443 individuals. Depression was assessed using the Major Depression Inventory (MDI) and neuroticism by the Swedish Scale of Personality (SSP). Outcomes of cardiovascular disease were register-based from the National inpatient register. RESULTS Both depression (OR 1.9 (95%CI 1.4, 2.5)) and high levels of neuroticism (OR 1.2 (95%CI 1.1-1.3)) were associated with increased risk of CVD. The combined effect of depression and neuroticism on the risk of CVD revealed HRs ranging from 1.0 to 1.9 after adjusting for age and gender, socioeconomic position, prevalent hypertension and diabetes. Almost similar associations were seen after further adjustment for lifestyle factors. CONCLUSION Neuroticism increased the risk of CVD in depressed persons. We found synergistic interaction between neuroticism and depression status in predicting future risk of CVD.
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Affiliation(s)
- Aysha Almas
- Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Jette Moller
- Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Romaina Iqbal
- Department of Medicine, Aga Khan University, Karachi, Pakistan
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Yvonne Forsell
- Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden
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Andreasson A, Schiller H, Åkerstedt T, Berntson E, Kecklund G, Lekander M. Brief report: Contemplate your symptoms and re-evaluate your health. A study on working adults. J Health Psychol 2017; 24:1562-1567. [DOI: 10.1177/1359105317715090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We investigated whether self-ratings of health are affected by a symptom rating. A diary including a one-item self-rating of health (“pre–self-rated health”; 1 = excellent, 7 = very poor), a subsequent 26-item rating of symptoms, and thereafter a second (identical) health rating (“post–self-rated health”) was completed by 820 persons 21 times. Self-rated health worsened significantly ( p < .0001) after the symptom rating, from 2.72 pre–self-rated health (95% confidence interval: 2.70–2.74) to 2.77 post–self-rated health (95% confidence interval: 2.75–2.79) and more so in persons who reported more symptoms ( b = .058, p < .05). The results support the notion that subjective health perception is influenced by attending to symptoms, especially so in persons with a high symptom burden.
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Affiliation(s)
- Anna Andreasson
- Stockholm University, Sweden
- Karolinska Institutet, Sweden
- Macquarie University, Australia
| | | | | | | | | | - Mats Lekander
- Stockholm University, Sweden
- Karolinska Institutet, Sweden
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23
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The relationship between clients’ personality traits, working alliance and therapy outcome in a training context. CURRENT ISSUES IN PERSONALITY PSYCHOLOGY 2017. [DOI: 10.5114/cipp.2017.65244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Sanatinia R, Wang D, Tyrer P, Tyrer H, Crawford M, Cooper S, Loebenberg G, Barrett B. Impact of personality status on the outcomes and cost of cognitive-behavioural therapy for health anxiety. Br J Psychiatry 2016; 209:244-50. [PMID: 27445356 PMCID: PMC5007454 DOI: 10.1192/bjp.bp.115.173526] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 02/08/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Health anxiety, hypochondriasis and personality disturbance commonly coexist. The impact of personality status was assessed in a secondary analysis of a randomised controlled trial (RCT). AIMS To test the impact of personality status using ICD-11 criteria on the clinical and cost outcomes of treatment with cognitive-behavioural therapy for health anxiety (CBT-HA) and standard care over 2 years. METHOD Personality dysfunction was assessed at baseline in 444 patients before randomisation and independent assessment of costs and outcomes made on four occasions over 2 years. RESULTS In total, 381 patients (86%) had some personality dysfunction with 184 (41%) satisfying the ICD criteria for personality disorder. Those with no personality dysfunction showed no treatment differences (P = 0.90) and worse social function with CBT-HA compared with standard care (P<0.03) whereas all other personality groups showed greater improvement with CBT-HA maintained over 2 years (P<0.001). Less benefit was shown in those with more severe personality disorder (P<0.05). Costs were less with CBT-HA except for non-significant greater differences in those with moderate or severe personality disorder. CONCLUSIONS The results contradict the hypothesis that personality disorder impairs response to CBT in health anxiety in both the short and medium term.
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Affiliation(s)
| | | | - Peter Tyrer
- Rahil Sanatinia, MD, Centre for Mental Health, Imperial College, London; Duolao Wang, PhD, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool; Peter Tyrer, FMedSci, Helen Tyrer, MRCGP, PhD, Mike Crawford, FRCPsych, Sylvia Cooper, BSc, Centre for Mental Health, Imperial College, London; Gemma Loebenberg, MSc, North West London Clinical Research Network, Hammersmith Hospital, London; Barbara Barrett, PhD, King's Health Economics, King's College London, London, UK
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25
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Fagerberg T, Söderman E, Gustavsson JP, Agartz I, Jönsson EG. Personality traits in established schizophrenia: aspects of usability and differences between patients and controls using the Swedish universities Scales of Personality. Nord J Psychiatry 2016; 70:462-9. [PMID: 27103375 PMCID: PMC4926784 DOI: 10.3109/08039488.2016.1159331] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Personality is considered as an important aspect that can affect symptoms and social function in persons with schizophrenia. The personality questionnaire Swedish universities Scales of Personality (SSP) has not previously been used in psychotic disorder. AIMS To investigate if SSP has a similar internal consistency and factor structure in a psychosis population as among healthy controls and if patients with psychotic disorders differ from non-psychotic individuals in their responses to the SSP. METHODS Patients with psychotic disorders (n = 107) and healthy controls (n = 119) completed SSP. SSP scores were analyzed for internal consistency and case-control differences by Cronbach's alfa and multiple analysis of covariance, respectively. RESULTS Internal consistencies among patients were overall similar to that of controls. The patients scored significantly higher in seven (Somatic trait anxiety, Psychic trait anxiety, Stress susceptibility, Lack of assertiveness, Detachment, Embitterment, Mistrust) and lower in three (Physical trait aggression, Verbal trait aggression, Adventure seeking) of the 13 scales of the inventory. In three scales (Impulsiveness, Social desirability and Trait irritability) there was no significant difference between the scoring of patients and healthy controls. CONCLUSION The reliability estimates suggest that SSP can be used by patients with psychotic disorders in stable remission. Patients score higher on neuroticism-related scales and lower on aggression-related scales than controls, which is in accordance with earlier studies where other personality inventories were used.
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Affiliation(s)
- Tomas Fagerberg
- a Human Brain Informatics (HUBIN), Department of Clinical Neuroscience, Psychiatry Section , Karolinska Institutet and Hospital , Stockholm , Sweden
| | - Erik Söderman
- a Human Brain Informatics (HUBIN), Department of Clinical Neuroscience, Psychiatry Section , Karolinska Institutet and Hospital , Stockholm , Sweden
| | - J Petter Gustavsson
- b Division of Psychology, Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
| | - Ingrid Agartz
- a Human Brain Informatics (HUBIN), Department of Clinical Neuroscience, Psychiatry Section , Karolinska Institutet and Hospital , Stockholm , Sweden ;,c NORMENT, KG Jebsen Centre for Psychosis Research , Institute of Clinical Medicine. Psychiatry section, University of Oslo , Norway ;,d Department of Psychiatric Research , Diakonhjemmet Hospital , Oslo , Norway
| | - Erik G Jönsson
- a Human Brain Informatics (HUBIN), Department of Clinical Neuroscience, Psychiatry Section , Karolinska Institutet and Hospital , Stockholm , Sweden ;,c NORMENT, KG Jebsen Centre for Psychosis Research , Institute of Clinical Medicine. Psychiatry section, University of Oslo , Norway
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26
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Dear BF, Staples LG, Terides MD, Karin E, Zou J, Johnston L, Gandy M, Fogliati VJ, Wootton BM, McEvoy PM, Titov N. Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for generalized anxiety disorder and comorbid disorders: A randomized controlled trial. J Anxiety Disord 2015; 36:63-77. [PMID: 26460536 DOI: 10.1016/j.janxdis.2015.09.003] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 08/25/2015] [Accepted: 09/07/2015] [Indexed: 11/29/2022]
Abstract
Generalized anxiety disorder (GAD) can be treated effectively with either disorder-specific cognitive behavior therapy (DS-CBT) or transdiagnostic CBT (TD-CBT). The relative benefits of DS-CBT and TD-CBT for GAD and the relative benefits of delivering treatment in clinician guided (CG-CBT) and self-guided (SG-CBT) formats have not been examined. Participants with GAD (n=338) were randomly allocated to receive an internet-delivered TD-CBT or DS-CBT intervention delivered in either CG-CBT or SG-CBT formats. Large reductions in symptoms of GAD (Cohen's d ≥ 1.48; avg. reduction ≥ 50%) and comorbid major depressive disorder (Cohen's d ≥ 1.64; avg. reduction ≥ 45%), social anxiety disorder (Cohen's d ≥ 0.80; avg. reduction ≥ 29%) and panic disorder (Cohen's d ≥ 0.55; avg. reduction ≥ 33%) were found across the conditions. No substantive differences were observed between DS-CBT and TD-CBT or CG-CBT and SG-CBT, highlighting the public health potential of carefully developed TD-CBT and SG-CBT.
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Affiliation(s)
- B F Dear
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
| | - L G Staples
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | - M D Terides
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | - E Karin
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | - J Zou
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | - L Johnston
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | - M Gandy
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | - V J Fogliati
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | - B M Wootton
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia; School of Medicine (Psychology), University of Tasmania, Tasmania, Australia
| | - P M McEvoy
- School of Psychology and Speech Pathology, Curtin University, Western Australia, Australia
| | - N Titov
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
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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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