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Lešin Gaćina D, Marčinko D, Kuzman T, Škegro I, Vidas Pauk S, Škegro B, Tomić M, Bulum T, Jandroković S. Personality dimensions and treatment adherence among glaucoma patients: the role of self-transcendence. Curr Med Res Opin 2024; 40:583-590. [PMID: 38404158 DOI: 10.1080/03007995.2024.2323644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/22/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Cloninger's psychobiosocial model of personality proposes that consistent patterns of health behavior are determined by the complex interaction of different neurobiological processes of the patient's temperament and character dimensions. Poor medication adherence is a pervasive problem among glaucoma patients and can lead to increased morbidity and disability. The objective of the present study was to investigate the association between Cloninger's personality dimensions and medication adherence among glaucoma patients. METHODS The cross-sectional study was conducted among 113 primary open-angle glaucoma (POAG) patients. The treatment adherence was assessed through a valid and reliable self-administered questionnaire, the Culig Adherence Scale (CAS). Personality dimensions were evaluated using the abbreviated version of the Temperament and Character Inventory-Revised (TCI-140). Statistical analyses were performed using TIBCO Statistica 14.0.1. The study protocol was registered in the DRKS - German Clinical Trials Register; (DRKS-ID: DRKS00022081). RESULTS According to CAS, only 39.8% of patients were adherent to glaucoma treatment. Adherence was significantly negatively related only to the character dimension of Self-Transcendence (p < 0.05). No other TCI-140 dimension was significantly associated with medication adherence (p > 0.05). CONCLUSIONS The results suggest that POAG patients with higher scores on the Self-Transcendent personality dimension are more likely to experience difficulties adhering to medication regimen. The study highlights the importance of a holistic approach to glaucoma treatment, which takes into account not only the biological aspects of disease but also the psychosocial factors that influence patient behavior. Healthcare providers may need to consider glaucoma patients' personality dimensions, beliefs and values when developing treatment plans and strategies to improve medication adherence.
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Affiliation(s)
- Dina Lešin Gaćina
- Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Darko Marčinko
- Department of Psychiatry and Psychological Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Tomislav Kuzman
- Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivan Škegro
- Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Sania Vidas Pauk
- Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | | | - Martina Tomić
- Department of Ophthalmology, Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia
| | - Tomislav Bulum
- School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Ophthalmology, Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia
| | - Sonja Jandroković
- Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Termine A, Fabrizio C, Gimenez J, Panuccio A, Balsamo F, Passarello N, Caioli S, Saba L, De Bardi M, Della Valle F, Orlando V, Petrosini L, Laricchiuta D. Transcriptomic and Network Analyses Reveal Immune Modulation by Endocannabinoids in Approach/Avoidance Traits. Int J Mol Sci 2022; 23:ijms23052538. [PMID: 35269678 PMCID: PMC8910341 DOI: 10.3390/ijms23052538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 02/04/2023] Open
Abstract
Approach and avoidance (A/A) tendencies are stable behavioral traits in responding to rewarding and fearful stimuli. They represent the superordinate division of emotion, and individual differences in such traits are associated with disease susceptibility. The neural circuitry underlying A/A traits is retained to be the cortico-limbic pathway including the amygdala, the central hub for the emotional processing. Furthermore, A/A-specific individual differences are associated with the activity of the endocannabinoid system (ECS) and especially of CB1 receptors whose density and functionality in amygdala differ according to A/A traits. ECS markedly interacts with the immune system (IS). However, how the interplay between ECS and IS is associated with A/A individual differences is still ill-defined. To fill this gap, here we analyzed the interaction between the gene expression of ECS and immune system (IS) in relation to individual differences. To unveil the deep architecture of ECS-IS interaction, we performed cell-specific transcriptomics analysis. Differential gene expression profiling, functional enrichment, and protein–protein interaction network analyses were performed in amygdala pyramidal neurons of mice showing different A/A behavioral tendencies. Several altered pro-inflammatory pathways were identified as associated with individual differences in A/A traits, indicating the chronic activation of the adaptive immune response sustained by the interplay between endocannabinoids and the IS. Furthermore, results showed that the interaction between the two systems modulates synaptic plasticity and neuronal metabolism in individual difference-specific manner. Deepening our knowledge about ECS/IS interaction may provide useful targets for treatment and prevention of psychopathology associated with A/A traits.
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Affiliation(s)
- Andrea Termine
- Data Science Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (A.T.); (C.F.)
| | - Carlo Fabrizio
- Data Science Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (A.T.); (C.F.)
| | - Juliette Gimenez
- Epigenetics and Genome Reprogramming Laboratory, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy;
| | - Anna Panuccio
- Experimental and Behavioral Neurophysiology Lab, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (A.P.); (F.B.); (N.P.); (L.P.)
- Department of Psychology, University Sapienza of Rome, 00185 Rome, Italy
| | - Francesca Balsamo
- Experimental and Behavioral Neurophysiology Lab, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (A.P.); (F.B.); (N.P.); (L.P.)
- Department of Human Sciences, Guglielmo Marconi University, 00193 Rome, Italy
| | - Noemi Passarello
- Experimental and Behavioral Neurophysiology Lab, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (A.P.); (F.B.); (N.P.); (L.P.)
- Department of Humanities, Federico II University of Naples, 80131 Naples, Italy
| | - Silvia Caioli
- Unit of Neurology, IRCCS Neuromed, 86077 Pozzilli, Italy;
| | - Luana Saba
- Department of Sciences and Technologies for Humans and Environment, University of Campus Biomedico, 00128 Rome, Italy;
| | - Marco De Bardi
- Neuroimmunology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy;
| | - Francesco Della Valle
- KAUST Environmental Epigenetics Program, Biological Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), 4700 KAUST, Thuwal 23955, Saudi Arabia; (F.D.V.); (V.O.)
| | - Valerio Orlando
- KAUST Environmental Epigenetics Program, Biological Environmental Science and Engineering Division, King Abdullah University of Science and Technology (KAUST), 4700 KAUST, Thuwal 23955, Saudi Arabia; (F.D.V.); (V.O.)
| | - Laura Petrosini
- Experimental and Behavioral Neurophysiology Lab, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (A.P.); (F.B.); (N.P.); (L.P.)
| | - Daniela Laricchiuta
- Experimental and Behavioral Neurophysiology Lab, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (A.P.); (F.B.); (N.P.); (L.P.)
- Correspondence:
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Michael KC, Bonneau RH, Bourne RA, Godbolt L, Caruso MJ, Hohmann C, Cavigelli SA. Divergent immune responses in behaviorally-inhibited vs. non-inhibited male rats. Physiol Behav 2019; 213:112693. [PMID: 31629765 PMCID: PMC6934092 DOI: 10.1016/j.physbeh.2019.112693] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 09/17/2019] [Accepted: 09/27/2019] [Indexed: 02/06/2023]
Abstract
Stable behavioral traits (temperament, personality) often predict health outcomes. Temperament-specific differences in immune function could explain temperament-specific health outcomes, however, we have limited information on whether immune function varies by personality. In the present study, we examined the relationship between a basic behavioral trait (behavioral-inhibition vs. non-inhibition) and two immune responses (innate inflammation and delayed-type hypersensitivity, DTH) in a rodent model. In humans, behavioral inhibition (fearful temperament) is associated with altered stress physiology and allergies. In laboratory rats, the trait is associated with elevated glucocorticoid production. We hypothesized that behavioral inhibition is associated with glucocorticoid resistance and dampened T-helper 1 cell responses often associated with chronic stress and allergies. Further, this immune profile would predict poorly-regulated innate inflammation and dampened DTH. In male Sprague-Dawley rats, we quantified consistent behavioral phenotypes by measuring latency to contact two kinds of novelty (object vs. social), then measured lipopolysaccharide(LPS)-induced innate inflammation or keyhole limpet hemocyanin(KLH)-induced DTH. Behaviorally-inhibited rats had heightened glucocorticoid and interleukin-6 responses to a low/moderate dose of LPS and reduced DTH swelling to KLH re-exposure compared to non-inhibited rats. These results suggest that behavioral inhibition is associated with a glucocorticoid resistant state with poorly regulated innate inflammation and dampened cell-mediated immune responses. This immune profile may be associated with exaggerated T-helper 2 responses, which could set the stage for an allergic/asthmatic/atopic predisposition in inhibited individuals. Human and animal models of temperament-specific immune responses represent an area for further exploration of mechanisms involved in individual differences in health.
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Affiliation(s)
- Kerry C Michael
- Department of Psychology, University of Minnesota, Morris, USA
| | - Robert H Bonneau
- Department of Microbiology and Immunology and Department of Pediatrics, The Pennsylvania State University Hershey Medical Center, USA
| | - Rebecca A Bourne
- Department of Biobehavioral Health, The Pennsylvania State University, USA
| | | | - Michael J Caruso
- Department of Biobehavioral Health, The Pennsylvania State University, USA; Center for Brain, Behavior, and Cognition, The Pennsylvania State University, USA
| | | | - Sonia A Cavigelli
- Department of Biobehavioral Health, The Pennsylvania State University, USA; Center for Brain, Behavior, and Cognition, The Pennsylvania State University, USA; Huck Institutes of the Life Sciences, The Pennsylvania State University, USA.
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Bronchial asthma control degree and the temperament structure according to the Eysenck model. Postepy Dermatol Alergol 2019; 37:559-565. [PMID: 32994779 PMCID: PMC7507172 DOI: 10.5114/ada.2019.83216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 01/31/2019] [Indexed: 02/07/2023] Open
Abstract
Introduction Asthma is a disease of a psychosomatic nature. The control of asthma is still poor in approximately 5% of patients, despite introduction of modern inhalant drugs and psychotherapeutic interventions. Aim To evaluate whether the degree of bronchial asthma control is related to the characteristics of temperament according to Eysenck’s concept. Material and methods The study was conducted on a group of 111 bronchial asthma patients and 44 healthy subjects. In all of them, the Eysenck temperament questionnaire was administered and the level of asthma control was determined. Results Increase in the scale of neuroticism was associated with an 1.83-fold increase in the likelihood of poor asthma control. Increase in the result on the psychoticism scale and lie scale of about one point was associated with a slightly smaller increased risk of poor asthma control (respectively: 1.49-fold and 1.61-fold). Conclusions The structure of temperament of a person with poor control of bronchial asthma can be characterized. Patients with poor asthma control have a higher level of neuroticism, psychoticism and propensity to lie, compared with the healthy population and subjects with good or partial bronchial asthma control.
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Temperament and stress coping styles in bronchial asthma patients. Postepy Dermatol Alergol 2016; 33:469-474. [PMID: 28035226 PMCID: PMC5183786 DOI: 10.5114/ada.2016.63886] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 11/24/2015] [Indexed: 01/15/2023] Open
Abstract
Introduction Temperament, defined as the formal characteristics of behavior, is a personality trait which can influence the clinical presentation and course of bronchial asthma. It determines susceptibility to stress as well as stress coping styles. Aim The aim of the study was to assess whether healthy subjects differ from bronchial asthma patients with regard to temperamental variables and stress coping styles, and whether these factors may also differentiate patients with severe asthma from those with the milder form. The study also assesses whether the results of flow volume curve analysis correlate with temperamental traits and stress coping styles. Material and methods The study was conducted in a group of 65 asthma patients and 62 healthy controls. All underwent flow volume curve examination and psychological tests: Formal Characteristics of Behavior – Temperament Inventory (FCB-TI) and Coping in Stress Situations (CISS) questionnaire. Results Bronchial asthma patients were characterized by a lower level of briskness (“agility”) than healthy subjects (13.35 ±4.48 vs. 14.97 ±3.98, p = 0.031). The remaining temperamental traits and stress coping styles did not differ between the groups. Additionally, the forced expiratory volume in 1 s (FEV1) value was found to correlate negatively with the intensity of the emotion-oriented stress coping style, whereas FEV1 and forced vital capacity (FVC) were found to positively correlate with briskness, emotional reactivity and endurance, while a negative correlation was found with activity. Conclusions Briskness differentiates healthy subjects from bronchial asthma patients. The values obtained in FEV1 and FVC pulmonary function tests were also found to correlate with some temperamental variables.
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Atay IM, Erturan I, Demirdas A, Yaman GB, Yürekli VA. The impact of personality on quality of life and disease activity in patients with Behcet's disease: a pilot study. Compr Psychiatry 2014; 55:511-7. [PMID: 24342057 DOI: 10.1016/j.comppsych.2013.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 10/19/2013] [Accepted: 11/08/2013] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the personality characteristics of patients with Behcet's Disease (BD) using the Temperament and Character Inventory (TCI) compared with healthy control subjects and to investigate the relationship between the temperament and character properties and quality of life, disease activity, depression and anxiety in Behcet's patients. METHODS A total of 46 BD patients and 40 healthy subjects were included in the study. All patients and controls were determined using the TCI, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Clinical Version for Axis I disorders (SCID-CV), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Quality of life (QOL) Instrument for Skin Disorders and Behcet Disease Current Activity Form (BDCAF). RESULTS BD patients demonstrated significantly lower Reward Dependence than healthy controls. Among the subscales; Explarotory Excitability, Shyness with Strangers, Attachment, Spiritual Acceptance were lower and Self-Acceptance was higher in patients compared to control subjects. Decreased quality of life and increased disease activity of the patients were correlated with increased anxiety and depression. Responsibility, Self-Forgetfulness and Transpersonal Identification were associated with quality of life while Responsibility was the major factor effecting QOL. Disease activity was not found related with TCI properties. CONCLUSION Temperament and Character traits of BD patients were different from healthy group that might be due to many factors like genetics, biological or socio-cultural differences. BD patients were demonstrated as materialistic, self-contained, self-confident, cold, detached, and reserved although they are not shy. Considering the different personality traits of BD patients in psychotherapeutic approaches, may have a positive impact on QOL and comorbid major depressive disorder.
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Affiliation(s)
- Inci Meltem Atay
- Suleyman Demirel University Department of Psychiatry, Isparta, Turkey.
| | - Ijlal Erturan
- Suleyman Demirel University Department of Dermatology, Isparta, Turkey.
| | - Arif Demirdas
- Suleyman Demirel University Department of Psychiatry, Isparta, Turkey.
| | - Gozde Bacık Yaman
- Suleyman Demirel University Department of Psychiatry, Isparta, Turkey.
| | - Vedat Ali Yürekli
- Suleyman Demirel University Department of Neurology, Isparta, Turkey.
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Kahraman H, Orhan FO, Sucakli MH, Ozer A, Koksal N, Sen B. Temperament and character profiles of male COPD patients. J Thorac Dis 2013; 5:406-13. [PMID: 23991295 DOI: 10.3978/j.issn.2072-1439.2013.07.11] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 07/03/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a respiratory disorder, and is characterized by persistent airflow obstruction. These patients are exposed to severe physical limitations and substantial psychosocial trouble. The aims of this study were to determine the temperament and character profiles of personality in patients with COPD and to compare the results with those of healthy controls. METHODS Thirty-nine male COPD patients and 67 age- and gender-matched healthy controls completed the self-administered 240-item temperament and character inventory (TCI) and 14-item hospital anxiety and depression scale. The relationships between temperament and character personality profiles and clinical factors such as severity of COPD, anxiety, and depression were evaluated. RESULTS COPD patients had significantly higher mean scores of Harm avoidance and lower mean score of Self-directedness than those of healthy controls. In the COPD patients, the anxiety score was significantly higher (P=0.03) and the depression score was found to be insignificantly higher than that of control group. The TCI profiles were not correlated with the severity of COPD. In COPD patients, Self-directedness and Cooperativeness traits of TCI character negatively correlated with anxiety, but any of traits did not correlate with depression. CONCLUSIONS The present study defined the Harm avoidance score was higher and Self-directedness was lower in COPD patients and the COPD severity did not correlate with any of the personality trait. We suggest that during evaluation of COPD patients for treatment, personality trait should also be considered in clinical practice.
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Affiliation(s)
- Hasan Kahraman
- Department of Chest Diseases, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras 46050, Turkey
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Ak M, Dincer D, Haciomeroglu B, Akarsu S, Cinar A, Lapsekili N. Temperament and character properties of primary focal hyperhidrosis patients. Health Qual Life Outcomes 2013; 11:5. [PMID: 23311945 PMCID: PMC3579690 DOI: 10.1186/1477-7525-11-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 10/15/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary focal hyperhidrosis is a health problem, which has negative effects on the patient's quality of life and significantly affects the patients' daily activities, social and business life. The aim of this study is to evaluate temperament and character properties of patients diagnosed with primary focal hyperhidrosis. METHODS Fifty-six primary focal hyperhidrosis (22.42 ± 7.80) and 49 control subjects (24.48 ± 5.17) participated in the study. Patients who met the diagnostic criteria for PFH were referred to psychiatry clinic where the subjects were evaluated through Structured Clinical Interview for DSM Disorders-I and Temperament and Character Inventory. RESULTS In order to examine the difference between the PFH and control group in terms of temperament and character properties, one-way Multivariate Analysis of Variance (MANOVA) was conducted. In terms of temperament properties, PFH group took significantly higher scores than control group in Fatigability and asthenia dimension. In terms of character properties, PFH group scored significantly lower than control group in Purposefulness, Resourcefulness, Self-Directedness and scored significantly higher than control group in Self-forgetfulness and Self-Transcendence. CONCLUSION Temperament and character features of PFH patients were different from healthy group and it was considered that these features were affected by many factors including genetic, biological, environmental, socio-cultural elements. During the follow-up of PFH cases, psychiatric evaluation is important and interventions, especially psychotherapeutic interventions can increase the chances of success of the dermatological treatments and can have a positive impact on the quality of life and social cohesion of chronic cases.
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Affiliation(s)
- Mehmet Ak
- Department of Psychiatry, Gulhane School of Medicine, Etlik, Ankara, 06018, Turkey.
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