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Oh HS, Cloninger CR. The role of temperament and character in the anxiety-depression spectrum among Korean adults. J Affect Disord 2024; 359:1-13. [PMID: 38759504 DOI: 10.1016/j.jad.2024.05.052] [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] [Received: 03/28/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Temperament and character are useful in risk assessment and therapy of individuals in the anxiety-depression spectrum but understudied in South Korea. OBJECTIVE The study aimed to identify the temperament and character features associated with anxiety and/or depression in individuals with clinical disorders and in the general population. METHODS A representative sample of 1384 Korean adults over 18 years old (58 % female) were assessed with the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Temperament and Character Inventory (TCI). Multivariate analyses, including structural equation modeling and complex systems analysis, evaluated how personality influenced risk and resilience for anxiety and/or depression. RESULTS The three groups with anxiety and/or depression were strongly distinguished by temperament and character: (i) In AD (n = 58), Harm Avoidance and Reward Dependence were higher than in DD, and Self-directedness was higher than in AD+DD; (ii) In DD (n = 90), Persistence, Self-Directedness and Cooperativeness were higher than in AD+DD; and (iii) In AD+DD (n = 101), Harm Avoidance was highest and Persistence and Self-directedness were lowest (i.e., they were lowest in Resilience). Structural equation models confirmed these risk relations with strong character development reducing the adverse effects of emotional hyperreactivity from extreme temperaments. LIMITATIONS Self-reports were measured only at one point in time, requiring collateral experimental data to support causal interpretation. CONCLUSIONS Interactions of temperament and character are strongly predictive of risk and resilience to anxiety and/or depression by regulating both positive and negative affect. Character mediates the adverse effects of extreme temperaments on affect.
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Affiliation(s)
- Hyun Sook Oh
- Department of Psychology and Childcare, College of Human Services, Hanshin University, Seoul, South Korea
| | - C Robert Cloninger
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
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Karppanen AK, Miettunen J, Hurtig T, Nordström T, Tammelin T, Korpelainen R. Temperament and longitudinal changes in physical activity - the Northern Finland Birth Cohort 1966 Study. BMC Public Health 2023; 23:426. [PMID: 36869293 PMCID: PMC9985204 DOI: 10.1186/s12889-023-15303-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/21/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Insufficient physical activity is risk factor for morbidity and premature mortality. This population-based birth cohort study investigated the cross-sectional and longitudinal associations between self-reported temperament at age 31 and self-reported leisure-time moderate to vigorous physical activity (MVPA) levels and changes thereof from the age of 31 to the age of 46 years. METHODS The study population comprised 3,084 subjects (1,359 male and 1,725 female) from the Northern Finland Birth Cohort 1966. MVPA was self-reported at ages 31 and 46 years. Novelty seeking, harm avoidance, reward dependence, and persistence and their subscales were measured using Cloninger's Temperament and Character Inventory at age 31. Four temperament clusters were used in the analyses: persistent, overactive, dependent, and passive. Logistic regression was used to evaluate the relationship between temperament and MVPA. RESULTS The persistent and overactive temperament profiles at age 31 were positively associated with higher MVPA levels both in young adulthood and in midlife, while the passive and dependent temperament profiles were associated with lower MVPA levels. The overactive temperament profile was associated with a decrease in MVPA levels from young adulthood to midlife among males. CONCLUSION A passive temperament profile characterized by high harm avoidance is associated with a higher risk of low MVPA level than other temperament profiles over the life cycle in females. The results suggest that temperament may play a role in determining the level and sustainability of MVPA. Individual targeting and intervention tailoring for promoting physical activity should consider temperament traits.
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Affiliation(s)
- Anna-Kaisa Karppanen
- Research Unit of Population Health, University of Oulu, PO Box 5000, 90014, Oulu, Finland. .,Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland.
| | - Jouko Miettunen
- Research Unit of Population Health, University of Oulu, PO Box 5000, 90014, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Tuula Hurtig
- Research Unit of Clinical Neuroscience, Psychiatry, University of Oulu, Oulu, Finland.,PEDEGO Research Unit, Child Psychiatry, University of Oulu, Oulu, Finland.,Clinic of Child Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Tanja Nordström
- Research Unit of Population Health, University of Oulu, PO Box 5000, 90014, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, Northern Finland Birth Cohorts, University of Oulu, Oulu, Finland
| | - Tuija Tammelin
- LIKES, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Raija Korpelainen
- Research Unit of Population Health, University of Oulu, PO Box 5000, 90014, Oulu, Finland.,Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
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Ahola A, Rautio N, Timonen M, Nordström T, Jääskeläinen E, Miettunen J. Premorbid temperament as predictor of onset of depression: 23-year follow-up. Compr Psychiatry 2023; 121:152359. [PMID: 36495692 DOI: 10.1016/j.comppsych.2022.152359] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/24/2022] [Accepted: 12/03/2022] [Indexed: 12/08/2022] Open
Abstract
BACKGROUND Previously Cloninger's temperament traits have been researched as a risk factor for depression mostly in cross-sectional studies. In these studies, especially high harm avoidance has been associated with an increased risk of depression. The main objective of this study was to investigate how temperament traits affect the risk of the onset of depression in a previously mentally healthy adult population. METHODS This study includes a follow-up period of 23 years from the age of 31 until 54 in the Northern Finland Birth Cohort 1966 Study. Temperament was measured at the 31-year follow-up using Temperament and Character Inventory (TCI). The outcome of the study was depressive disorder diagnosis during the follow-up in both sexes. To be able to take correlations between temperament traits we also did an analysis using temperament clusters. RESULTS Our sample size was 3999 individuals, out of which 240 were diagnosed with depression. For women an increase in the TCI score for novelty seeking (NS), harm avoidance (HA) or persistence (P) increased the risk of depression during the follow-up. For men only HA was a significant predictor of depression. An increase in reward dependence (RD) was found to reduce the risk of psychotic depression. In the analysis using the temperament clusters, the cluster including shy and pessimistic individuals was associated with risk for depression diagnosis in men. CONCLUSIONS This prospective general population-based cohort study added to previous knowledge of high HA being a risk factor for depression, but it also found new associations such as higher P and NS.
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Affiliation(s)
- Aleksi Ahola
- Research Unit of Population Health, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland.
| | - Nina Rautio
- Research Unit of Population Health, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Markku Timonen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Tanja Nordström
- Research Unit of Population Health, University of Oulu, Oulu, Finland; Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Erika Jääskeläinen
- Research Unit of Population Health, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Research Unit of Population Health, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Scholte-Stalenhoef AN, Pijnenborg GHM, Hasson-Ohayon I, Boyette LL. Personality traits in psychotic illness and their clinical correlates: A systematic review. Schizophr Res 2023; 252:348-406. [PMID: 36804473 DOI: 10.1016/j.schres.2023.01.001] [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: 01/17/2022] [Revised: 12/18/2022] [Accepted: 01/02/2023] [Indexed: 02/17/2023]
Abstract
This systematic review focuses on personality traits according to both the Five Factor Model and Cloninger Psychobiological Model in relation to treatment related outcome variables across all stages of clinical psychotic illness. Search of Pubmed and Psychinfo databases led to final inclusion of 65 studies, which were ranked on quality and analyzed according to the associations between personality and outcome. Main findings are that higher levels of Harm Avoidance and Neuroticism are associated with higher symptom levels, tendency towards passive coping, greater self-stigma, lower quality of life, and Harm Avoidance to higher suicidality. Higher levels of Extraversion and higher levels of Self-Directedness are associated with more preference for active coping, more intrinsic motivation and higher self-esteem. Higher Novelty Seeking is related to more substance use and aggression, in men specifically. On outcome of trauma, care consumption and duration of untreated illness no consistent associations with personality traits were found. Combined evidence from both personality models however reveals a consistent pattern of personality traits related to clinical outcome in psychotic disorder, which is discussed in a dimensional manner.
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Affiliation(s)
- Anne Neeltje Scholte-Stalenhoef
- Ziekenhuis Groep Twente, Department of Psychiatry, Almelo, the Netherlands; University of Groningen, Department of Psychology, Groningen, the Netherlands.
| | | | | | - Lindy-Lou Boyette
- University of Amsterdam, Department of Clinical Psychology, Amsterdam, the Netherlands
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Chung ML, Seib-Pfeifer LE, Elling C, Geiser F, Forstner AJ, Schumacher J, Conrad R. Personality subtypes in adults with social anxiety disorder - novelty seeking makes the difference. BMC Psychiatry 2022; 22:832. [PMID: 36575407 PMCID: PMC9793521 DOI: 10.1186/s12888-022-04484-z] [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] [Received: 09/22/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Up to now several subtypes of social anxiety disorder (SAD) have been proposed. METHODS In the present study, we used a cluster analytic approach to identify qualitatively different subgroups of SAD based on temperament characteristics, that is, harm avoidance (HA) and novelty seeking (NS) dimensions of Cloninger's Temperament and Character Inventory. RESULTS Based on a large, diverse clinical sample (n = 575), we found evidence for two distinct subgroups of SAD: a larger (59%) prototypic, inhibited cluster characterized by high HA and low NS, and a smaller atypic, and comparatively more impulsive cluster characterized by medium to high HA and increased NS. The subgroups differed regarding a variety of sociodemographic and clinical variables. While the prototypic SAD subtype suffered from more severe SAD and depressive symptoms, suicidal ideation, and reduced social functioning, the atypic NS subtype showcased higher reproductive behaviour, self-directedness and -transcendence, comparatively. Additional hierarchical logistic regression highlights the contribution of age and education. CONCLUSIONS Our results valuably extend previous evidence for the existence of at least two distinct subtypes of SAD. A better knowledge of the characteristic differences in prototypic behaviour, personality, coping strategies and comorbidities between the identified (and further) subtypes can contribute to the development of effective prevention interventions and promotes the conceptualization of tailored treatments.
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Affiliation(s)
- Man-Long Chung
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
| | - Laura-Effi Seib-Pfeifer
- grid.10388.320000 0001 2240 3300Department of Psychology, University of Bonn, Kaiser-Karl-Ring 9, 53111 Bonn, Germany
| | - Christina Elling
- grid.15090.3d0000 0000 8786 803XDepartment of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Franziska Geiser
- grid.15090.3d0000 0000 8786 803XDepartment of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany
| | - Andreas J. Forstner
- grid.10388.320000 0001 2240 3300Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany ,grid.8385.60000 0001 2297 375XInstitute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Wilhelm-Johnen-Straße, 52428 Jülich, Germany ,grid.10253.350000 0004 1936 9756Centre for Human Genetics, University of Marburg, Baldingerstraße, 35033 Marburg, Germany
| | - Johannes Schumacher
- grid.10253.350000 0004 1936 9756Centre for Human Genetics, University of Marburg, Baldingerstraße, 35033 Marburg, Germany
| | - Rupert Conrad
- grid.15090.3d0000 0000 8786 803XDepartment of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Venusberg Campus 1, 53127 Bonn, Germany ,grid.16149.3b0000 0004 0551 4246Department of Psychosomatic Medicine and Psychotherapy, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany
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6
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Choi JY, Lee JY. Association between personality profiles and symptomatology patterns based on TCI and MMPI-2-RF in a transdiagnostic psychiatric sample: A person-centered approach. J Psychiatr Res 2022; 155:347-354. [PMID: 36179415 DOI: 10.1016/j.jpsychires.2022.09.031] [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] [Received: 03/13/2022] [Revised: 08/25/2022] [Accepted: 09/16/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The temperament and character dimensions of personality appear to be networking structures that interact nonlinearly. Previous studies have attempted to classify temperament and character subtypes using a person-centered approach but have been unable to explore the relationship between the combination of temperament and character and psychopathology patterns in a transdiagnostic sample. The purpose of this study was to examine how symptomatology patterns differ according to individuals' personality profiles, employing a psychobiological model in a transdiagnostic psychiatric sample. METHODS Participants were 1881 patients who visited the psychiatry department of a major medical hospital in Seoul, Korea, and completed both the Temperament Character Inventory (TCI) and the Minnesota Multiphasic Personality Inventory-2-Restructed Form (MMPI-2-RF) as part of their psychological evaluation. We performed two separate latent profile analyses using four temperament and four character indicators of the TCI to identify personality profiles and nine restructured clinical scales of the MMPI-2-RF to identify symptom patterns. RESULTS Five personality classes emerged: "vulnerable-maladaptive," "stable-adaptive," "average," "inhibited-neurotic," and "impulsive-irrational." Moreover, six symptom classes emerged: "non-distressed," "depressed," "emotionally-distressed," "average," "dysfunctional thoughts," and "confused." The personality profiles comprising a combination of rigid temperament and immature character were related to patterns of more severe subjective pain and symptoms. However, profiles with less rigid temperament and less immature character exhibited more diverse symptom patterns. CONCLUSIONS This study examined the relationship between personality profiles and symptomatology patterns, suggesting that understanding patients' personality profiles may be helpful in predicting symptom manifestation and establishing treatment plans.
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Affiliation(s)
- Ji Young Choi
- Department of Child Studies, Inha University, Incheon, Republic of Korea
| | - Joo Young Lee
- Department of Child Development and Education, Dongduk Women's University, Seoul, Republic of Korea.
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Komasi S, Hemmati A, Rezaei F, Rahmani K, Miettunen J, Amianto F, Hopwood CJ. Comparison of the relative sensitivity of two dimensional personality models to the psychopathological symptoms: the section III DSM-5 maladaptive traits versus affective temperaments. BMC Psychiatry 2022; 22:503. [PMID: 35897003 PMCID: PMC9327203 DOI: 10.1186/s12888-022-04156-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Personality Inventory for DSM-5 (PID-5) and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) are tools designed for personality dispositions for mental health symptoms. The present study was conducted to compare these models in terms of their relative sensitivity to the symptoms of personality disorders (PDs) and non-personality disorders (NPDs). METHODS Subjects in this cross-sectional study were 1232 (805 female; 63.5%) community samples in western Iran. Data were collected using the PID-5, the TEMPS-A, the Symptom Checklist-90 (SCL-90-R), and the Personality Diagnostic Questionnaire (PDQ-4). Correlations and Regression models were used to examine associations between traits and symptoms. RESULTS Maladaptive traits assessed by the PID-5 were more strongly associated with PD symptoms, whereas affective temperaments measured by the TEMPS-A were more strongly associated with NPD symptoms. CONCLUSION The present findings highlighted the practical utility of both the PID-5 and TEMPS-A indicating risk for psychopathology, but also suggest a distinction between PDs and NPDs in terms of underlying personality dispositions.
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Affiliation(s)
- Saeid Komasi
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran. .,Neurosciences Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Azad Hemmati
- grid.411189.40000 0000 9352 9878Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Farzin Rezaei
- Neurosciences Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran. .,Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Khaled Rahmani
- grid.484406.a0000 0004 0417 6812Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Jouko Miettunen
- grid.10858.340000 0001 0941 4873Center for Life Course Health Research, University of Oulu, & Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Federico Amianto
- grid.7605.40000 0001 2336 6580Department of Neurosciences, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Torino, Torino, Italy
| | - Christopher J. Hopwood
- grid.7400.30000 0004 1937 0650Department of Psychology, University of Zurich, Zurich, Switzerland
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Personality traits and night eating syndrome in women with bulimia nervosa and binge eating disorder. Eat Weight Disord 2022; 27:803-812. [PMID: 34059970 PMCID: PMC8933296 DOI: 10.1007/s40519-021-01221-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/20/2021] [Indexed: 11/05/2022] Open
Abstract
PURPOSE Previous research suggests that eating disorders may be associated with certain personality profiles; however, there is limited research investigating associations with night eating syndrome (NES). This research suggests harm avoidance personality trait is higher in NES individuals than in the general population, however, evidence of associations with other personality traits is inconsistent. To understand which personality traits are associated with NES symptoms, the current study aimed to improve understanding of the relationship between NES symptoms and a range of personality traits, addressing limitations in the earlier literature in this area by controlling for common confounders. METHODS Baseline data were analysed from an outpatient psychotherapy trial for 111 women with bulimia nervosa or binge eating disorder. Pre-treatment measures of personality traits (measured with the Temperament and character inventory-revised) and NES symptoms (measured with the Night eating questionnaire) were used. Regression analyses tested associations between these variables, adjusting for potential confounders, including age and ethnicity. RESULTS Low cooperativeness scores were associated with greater NES symptoms in the multivariable model (mean difference: - 0.10, 95% confidence intervals: - 0.20 to - 0.01, p = 0.033). There was weak evidence of associations between both high harm avoidance and low self-directedness personality traits and greater NES symptoms. CONCLUSIONS This study adds to the limited research measuring associations between a range of personality traits and NES, addressing limitations of previous research. Weak evidence for an association between high harm avoidance and low self-directedness and increased NES symptoms was found. A novel association was found between low cooperativeness and greater NES symptoms. Further research is needed to validate its presence in those with and without comorbid eating disorders and to examine the relative change in NES, eating disorder symptoms and personality scores in treatments focusing on cooperativeness. LEVEL OF EVIDENCE Level IV (cross-sectional data from a randomised controlled trial, CTB/04/08/139).
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Komasi S, Rezaei F, Hemmati A, Rahmani K, Amianto F, Miettunen J. Comprehensive meta-analysis of associations between temperament and character traits in Cloninger's psychobiological theory and mental disorders. J Int Med Res 2022; 50:3000605211070766. [PMID: 34994240 PMCID: PMC8743952 DOI: 10.1177/03000605211070766] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 12/15/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To explore the relationship between temperament and character traits in Cloninger's psychobiological theory and mental disorders.Methods: A systematic literature search was conducted of five international databases for all articles published in English between January 1990 and April 2019 (PROSPERO-CRD42019133214). Owing to heterogeneity, pooled estimates of correlations for personality disorders and standardized mean differences for case-control studies related to other mental disorders were calculated using the random-effects method. RESULTS The pooled effect sizes obtained from 149 studies showed that high harm avoidance (related to 22/24 diagnostic categories), low self-directedness (21/23), low cooperativeness (17/23), high self-transcendence (14/23), low reward dependence (11/24), high novelty-seeking (10/24), low novelty-seeking (7/24), high persistence (2/23), low persistence (2/23) and high reward dependence (2/24) were related to psychopathology. CONCLUSIONS All traits provided unique psychobiological tools for differential diagnosis of mental disorders. However, high harm avoidance and low self-directedness played a canonical role in psychopathology. Despite the study limitations, additional studies are warranted to evaluate the differential diagnoses suggested by the present model.
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Affiliation(s)
- Saeid Komasi
- Student Research Committee,
Kurdistan University of Medical Sciences, Sanandaj, Iran
- Neurosciences Research Center,
Research Institute for Health Development, Kurdistan University of Medical
Sciences, Sanandaj, Iran
| | - Farzin Rezaei
- Neurosciences Research Center,
Research Institute for Health Development, Kurdistan University of Medical
Sciences, Sanandaj, Iran
| | - Azad Hemmati
- Department of Psychology, University of Kurdistan, University of Kurdistan, Sanandaj, Iran
| | - Khaled Rahmani
- Liver and Digestive Research
Center, Research Institute for Health Development, Kurdistan University of
Medical Sciences, Sanandaj, Iran
| | - Federico Amianto
- Department of Neurosciences,
Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of
Torino, Torino, Italy
| | - Jouko Miettunen
- Center for Life Course Health
Research, University of Oulu, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu
University Hospital, Oulu, Finland
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Yomogida Y, Ota M, Matsuo J, Ishida I, Hidese S, Teraishi T, Sato N, Matsuda H, Hattori K, Kunugi H. Neuroanatomical basis of harm avoidance personality traits in major depressive disorder. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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11
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Haynos AF, Wang SB, LeMay-Russell S, Lavender JM, Pearson CM, Mathis KJ, Peterson CB, Crow SJ. An empirical taxonomy of reward response patterns in a transdiagnostic eating disorder sample. Eat Behav 2021; 42:101531. [PMID: 34126343 PMCID: PMC8380651 DOI: 10.1016/j.eatbeh.2021.101531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 05/14/2021] [Accepted: 05/19/2021] [Indexed: 11/26/2022]
Abstract
Reward response patterns may contribute to risk and maintenance of eating disorders (EDs), and there may be clinically meaningful heterogeneity in behavioral responses to different actual and anticipated rewards across ED diagnoses. We used an empirical approach to classify individuals with EDs based on self-reported tendencies for responding to reward-related stimuli. Latent profile analysis was conducted in a transdiagnostic ED sample (N = 104) using Temperament and Character Inventory (Cloninger et al., 1993) subscales to categorize participants on reward responses of behavioral activation towards immediate, hedonic rewards (Novelty Seeking subscale), persistence towards long-term rewards (Persistence subscale), and maintenance by social rewards (Reward Dependence subscale) rewards. Two profiles were identified: (1) Behavioral Activation group (elevated Novelty Seeking; n = 62); and (b) Behavioral Persistence group (elevated Persistence; n = 42). Generalized linear models comparing profiles showed that frequency of these reward response profiles did not differ in probable AN, BN, or OSFED groups; however, individuals with probable BED more often demonstrated the Behavioral Activation profile (p = .041). These profiles exhibited comparable ED severity, but different presentations. Across probable ED diagnoses, the Behavioral Activation group reported greater binge eating (p = .006, d = 0.32) and had higher BMIs (p = .001, d = 0.57); the Behavioral Persistence group endorsed greater driven exercise (p = .042, d = 0.33). Categorization by activation to novel, immediate rewards versus persistence towards long-term rewards was associated with different symptoms across diagnoses, potentially supporting the role of specific reward response profiles in ED phenomenology.
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Affiliation(s)
- Ann F. Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | | | - Sarah LeMay-Russell
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda MD
| | - Jason M. Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD,Metis Foundation; San Antonio, TX
| | - Carolyn M. Pearson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Karen J. Mathis
- College of Nursing, University of Rhode Island, Providence, RI
| | - Carol B. Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Scott J. Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN,The Emily Program, Minneapolis, MN, USA
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12
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Rezaei F, Hemmati A, Rahmani K, Komasi S. A systematic review of personality temperament models related to somatoform disorder with main focus on meta-analysis of Cloninger's theory components. Indian J Psychiatry 2020; 62:462-469. [PMID: 33678825 PMCID: PMC7909032 DOI: 10.4103/psychiatry.indianjpsychiatry_345_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/25/2020] [Accepted: 08/18/2020] [Indexed: 01/14/2023] Open
Abstract
The systematic review aims to identify four personality temperament models related to somatoform disorder with the main focus on the meta-analysis of temperaments and characters in Cloninger's theory. The literature search was performed on PubMed (Medline), Scopus, Web of Science, Cochrane, and ProQuest for all articles published in English from January 1990 to April 2019. Due to heterogeneity, pooled estimates of the standard mean difference between cases and controls were calculated using the random-effects model. Based on our inclusion criteria, 14 studies were identified, 7 of which were included in the meta-analysis. The results show that there is a significant difference between cases and controls with regard to harm avoidance (HA) (z = 5.322, P < 0.001), self-directedness (z = -4.719, P < 0.001), and self-transcendence (z = 2.848, P = 0.004). Compared to controls, HA and self-transcendence were higher and self-directedness was lower in cases. With regard to other subscales, there was no difference between the two groups (P > 0.05). The publication bias was not seen (P > 0.05 for Egger statistics). Up to now, very few studies have been focused on the relationship between personality temperament models and somatoform disorder. Among the components of the Cloninger's model, the poor self-directedness along with the abnormally high self-transcendence and HA is the personality component related to the somatoform disorder. Thus, Cloninger's model may potentially draw a personality profile for vulnerability to somatoform disorder. Given the limited number of studies available, future studies may challenge the results of the present study.
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Affiliation(s)
- Farzin Rezaei
- Neurosciences Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Azad Hemmati
- Department of Psychology, University of Kurdistan, Sanandaj, Iran
| | - Khaled Rahmani
- Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Saeid Komasi
- Neurosciences Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Haynos AF, Lavender JM, Nelson J, Crow SJ, Peterson CB. Moving towards specificity: A systematic review of cue features associated with reward and punishment in anorexia nervosa. Clin Psychol Rev 2020; 79:101872. [PMID: 32521390 DOI: 10.1016/j.cpr.2020.101872] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/16/2020] [Accepted: 05/24/2020] [Indexed: 12/13/2022]
Abstract
Models of anorexia nervosa (AN) posit that symptoms are maintained through deficient reward and enhanced punishment processing. However, theoretical and empirical inconsistencies highlight the need for a more nuanced conceptualization of this literature. Our goal was to comprehensively review the research on reward and punishment responding in AN from a cue-specific lens to determine which stimuli evoke or discourage reward and punishment responses in this population, and, ultimately, what properties these rewarding and punishing cues might share. A systematic review interrogating reward and punishment responses to specific cues yielded articles (n = 92) that examined responses to disorder relevant (e.g., food) and irrelevant (e.g., money) stimuli across self-report, behavioral, and biological indices. Overall, in most studies individuals with AN exhibited aversive responses to cues signaling higher body weights, social contexts, and monetary losses, and appetitive responses to cues for weight loss behaviors and thinness. Findings were more mixed on responses to palatable food and monetary gains. Results highlight that reward and punishment responding in AN are context specific and may be affected by varied stimulus qualities (e.g., predictability, controllability, delay, effort). Increasing specificity in future research on reward and punishment mechanisms in AN will better inform development of precisely-targeted interventions.
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Affiliation(s)
- Ann F Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States of America.
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America; The Metis Foundation, San Antonio, TX, United States of America
| | - Jillian Nelson
- Department of Psychology, George Mason University, Fairfax, VA, United States of America
| | - Scott J Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States of America; The Emily Program, St. Paul, MN, United States of America
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States of America; The Emily Program, St. Paul, MN, United States of America
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Naturalistic follow-up of subjects affected with anorexia nervosa 8 years after multimodal treatment: Personality and psychopathology changes and predictors of outcome. Eur Psychiatry 2020; 45:198-206. [DOI: 10.1016/j.eurpsy.2017.07.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/20/2017] [Accepted: 07/21/2017] [Indexed: 11/19/2022] Open
Abstract
AbstractBackground:Eating disorders (EDs) are serious mental illnesses of growing clinical and social impact. Despite their severity, there is still no satisfactory evidence-based treatment. Follow-up investigations are the most reliable studies to enlighten long-term outcome predictors and modifiers.Methods:In total, 59 subjects affected with anorexia nervosa were assessed 8 years after their admission into an outpatient multimodal treatment program for eating disorders. The follow-up changes in diagnostic criteria were compared with Chi-square test. Improved and not-improved subjects were compared. Clinical, personality and psychopathology features between T0 and T1 were compared with t-test for repeated measures. Correlation between T0 features and changes at T1 in personality and psychopathology features were assessed.Results:The rate of complete remission was 42%, an overall rate of 67.8% improved, a rate of 18.6% worsened. Concerning personality, a significant decrease of harm avoidance and increase in self-directedness were evidenced. Interoceptive awareness, drive for thinness, bulimia were significantly reduced at follow-up. Many T0 personality facets were related to personality and psychopathology improvement at follow-up.Conclusion:Multimodal treatment encompassing psychiatric, nutritional and psychological approaches is at the moment the most reliable approach for the treatment of moderate to severe anorexia nervosa with a discrete rate of improvement. Some personality and psychopathology characteristics may represent specific factors which favor resistance and impair improvement. Future approaches should consider the personalization of therapeutic approach according to these features.
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15
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Choi JY, Gim MS, Lee JY. Predictability of temperaments and negative experiences on higher-order symptom-based subtypes of depression. J Affect Disord 2020; 265:18-25. [PMID: 31957688 DOI: 10.1016/j.jad.2020.01.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 11/18/2019] [Accepted: 01/05/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The identification of subtypes of depression based on higher-order symptoms of emotional, thought, and behavioral dysfunction will broaden understanding of the heterogeneity in depression. Furthermore, exploring the ability of temperaments and negative experiences to predict each subtype is an effective way of facilitating treatment decisions. METHODS Participants were 417 patients diagnosed with depressive disorder at the psychiatry department of a major medical hospital in Seoul, Korea. A latent profile analysis was performed based on three higher-order scales of the MMPI-2-RF: Emotional/Internalizing Dysfunction, Thought Dysfunction, and Behavioral/Externalizing Dysfunction. Four temperament dimensions were assessed by the Temperament and Character Inventory-Revised-Short, and negative experiences including recent negative life events, number of lifetime traumatic events, and severity of maltreatment, were used as covariates in a multinomial regression analysis. RESULTS Four classes were obtained from the latent profile analysis: a "severe mood class" (39.8%), a "moderate mood class" (37.4%), a "mild mood class" (11.3%), and a "severe mood/thought class" (11.5%). Among temperament dimensions, high harm avoidance and low persistence significantly predicted more severe mood classes. Low reward dependence, number of lifetime traumatic events, and severity of maltreatment in negative experiences were significant predictors of the severe mood/thought class. LIMITATIONS This study could not explain the more detailed heterogeneity within depression because of over-inclusiveness of the higher-order scales. CONCLUSIONS This study identified three latent classes that differed in emotional severity and one other class with thought problems. The distinct dimensions of temperament and different types of negative experiences predicted the identified subtypes.
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Affiliation(s)
- Ji Young Choi
- Department of Child Studies, Inha University, Incheon, Republic of Korea
| | - Min Sook Gim
- Department of Psychiatry, Sanggye Baik Hospital, Inje University
| | - Joo Young Lee
- Department of Child Development and Education, Dongduk Women's University, Seoul, Republic of Korea.
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Abstract
Personality variables have long been implicated in the onset and maintenance of eating disorders, as well as in symptom divergence between anorexia nervosa and bulimia nervosa. Clinical observations are broadly supported by the data, with restricting anorexia nervosa associated with higher levels of constraint and Persistence, and binge-purge behaviors linked to the tendency to take impulsive action when emotionally distressed. Considerable heterogeneity is found within diagnostic categories, however, suggesting that different personality structures may predispose individuals to develop disordered eating through alternative pathways.
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Affiliation(s)
- Allison F Wagner
- Department of Psychology, University of Hawai'i at Mānoa, 2530 Dole Street, Sakamaki C400, Honolulu, HI 96826, USA.
| | - Kelly M Vitousek
- Department of Psychology, University of Hawai'i at Mānoa, 2530 Dole Street, Sakamaki C400, Honolulu, HI 96826, USA
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Gurpegui D, Ortuño F, Gurpegui M. Temperament traits and remission of depression: A naturalistic six-month longitudinal study. J Affect Disord 2019; 243:494-502. [PMID: 30286414 DOI: 10.1016/j.jad.2018.09.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 08/22/2018] [Accepted: 09/15/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND The aim of this naturalistic longitudinal study was to add evidence regarding the potential of Cloninger's temperament traits (novelty seeking, harm avoidance, reward dependence and persistence) for predicting the effect of pharmacological treatment on the rates of therapeutic response and remission. METHODS The study was based on 200 outpatients with unipolar depressive disorders of different severity and course of illness, and extended up to 6 months of follow-up. Patients were assessed in their temperament with the Tridimensional Personality Questionnaire (TPQ) and their condition was classified (in course and severity) according to the International Classification of Diseases, Tenth revision (ICD-10) diagnostic criteria for research. Patients were blindly rated (concerning other predicting variables) on the improved Clinical Global Impression-Severity scale for depression (iCGI-S) at baseline, 6 weeks, 3 months and 6 months. Outcome measures at the last observation carried forward were therapeutic response (reduction of ≥50% in the last iCGI-S) and remission (last iCGI-S = 0), which were available for 187 patients. RESULTS Remission was independently and directly associated with length of follow-up, and inversely with the baseline iCGI-S score and harm avoidance (patients in the high tertile had a 2.7 likelihood of non-remission in comparison with those in the low tertile); persistence was found to have a complex, V-shape relationship with remission. Within a sub-sample of more severe cases (n = 118), having higher harm avoidance scores, a more favorable outcome was associated with higher reward dependence and the non-smoking condition. LIMITATIONS With a naturalistic, non-experimental design, the sample may not be representative of the general population. CONCLUSIONS Temperament traits may help predict outcome in patients treated for depression.
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Affiliation(s)
- David Gurpegui
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain
| | - Felipe Ortuño
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain
| | - Manuel Gurpegui
- Department of Psychiatry, Faculty of Medicine, CTS-549 Research Group, Institute of Neurosciences, Universidad de Granada, Av. Investigación 11 - Torre A, Planta 9, E-18071 Granada, Spain.
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Moreira P, Cunha D, Inman RA. Achievement Emotions Questionnaire-Mathematics (AEQ-M) in adolescents: Factorial structure, measurement invariance and convergent validity with personality. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2018. [DOI: 10.1080/17405629.2018.1548349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Paulo Moreira
- Instituto de Psicologia e de Ciências da Educação, Universidade Lusíada-Norte (Porto), Porto, Portugal
- Centro de Investigação em Psicologia para o Desenvolvimento (CIPD), Universidade Lusíada-Norte (Porto), Porto, Portugal
| | - Diana Cunha
- Centro de Investigação em Psicologia para o Desenvolvimento (CIPD), Universidade Lusíada-Norte (Porto), Porto, Portugal
| | - Richard A. Inman
- Centro de Investigação em Psicologia para o Desenvolvimento (CIPD), Universidade Lusíada-Norte (Porto), Porto, Portugal
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Dell’Orco S, Sperandeo R, Moretto E, Maldonato NM. Revision on Psychometric Properties of the Temperament and Character Inventory in a Clinical Sample. Front Psychol 2018; 9:1951. [PMID: 30369898 PMCID: PMC6194178 DOI: 10.3389/fpsyg.2018.01951] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 09/21/2018] [Indexed: 11/13/2022] Open
Abstract
Cloninger's Temperament and Character Inventory (TCI) although elaborated on the general population, is frequently used in clinical samples. The study evaluates the psychometric characteristics of TCI in clinical populations with the aim of creating a reduced version of the test suitable for these subjects. This research was conducted on two groups of mental health outpatients. In the first study, 44 items, correlated with the psychiatric disorders, was selected. These items, divided in four dimensions utilizing both statistic and psychopathological criteria, show good internal consistency and external validity and constitute a Reduced Version (TR-TCI) of the test. In the second study, the predictive validity of the TR-TCI was evaluated through the ROC curves and a logistic regression model. The results show a good predictive validity of TR-TCI, that allows us to use this instrument in order to identify the personality structures that make people sensitive to psychiatric pathologies.
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Affiliation(s)
- Silvia Dell’Orco
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | | | - Enrico Moretto
- School of Integrated Gestalt Psychotherapy, Torre Annunziata, Italy
| | - Nelson Mauro Maldonato
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
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Vladimirov D, Niemelä S, Keinänen-Kiukaanniemi S, Ala-Mursula L, Auvinen J, Timonen M, Miettunen J. Cloninger's Temperament Dimensions and Longitudinal Alcohol Use in Early Midlife: A Northern Finland Birth Cohort 1966 Study. Alcohol Clin Exp Res 2018; 42:1924-1932. [PMID: 30063251 DOI: 10.1111/acer.13857] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 07/27/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Temperament is theorized to be an important factor contributing to the development of alcohol use disorder, but longitudinal studies on how temperament is related to alcohol use among general population in midlife are scarce. Our aims were to investigate potentially reciprocal associations between temperament and changes in alcohol use from age 31 to 46 using prospective birth cohort data. METHOD Within the Northern Finland Birth Cohort 1966, alcohol use and temperament were studied at ages 31 and 46. Participants (N = 5,274) were classified into moderate users, abstainers and heavy users based on their mean alcohol use (g/d). Additionally, participants were categorized as steady users, reducers, or increasers. Multinomial regression analyses were conducted with Cloninger's Temperament and Character Inventory (TCI) scores as factors influencing alcohol use using moderate and stable users as reference groups. Reciprocity of relations was assessed with cross-lagged structural equation modeling. RESULTS Temperament and alcohol use are rather stable in midlife. Novelty seeking (NS) predicted heavy use (OR = 1.4; CI: 1.3 to 1.6 for men, OR = 1.3; CI: 1.1 to 1.5 for women) and increasing use (OR = 1.2; CI: 1.1 to 1.4 for men, OR = 1.1; CI: 1.0 to 1.3 for women), whereas low NS predicted abstaining among women (OR = 0.7; CI: 0.6 to 0.8). High harm avoidance (HA) predicted abstaining (OR = 1.3; CI: 1.1 to 1.5) for men. Low persistence (P) among men predicted both abstaining (OR = 0.9; CI: 0.7 to 0.98) and heavy use (OR = 0.9; CI: 0.8 to 0.98). Among women, low reward dependence (RD) predicted heavy use (OR = 0.8; CI: 0.7 to 0.9). Among TCI scores, only NS predicted increasing use in the cross-lagged models. CONCLUSIONS Temperament has an impact on alcohol use in midlife. Of the TCI dimensions, only NS seems to predispose to increased alcohol use and problem use throughout life. Additionally, RD among women and P among men are significant factors from a life-course perspective. Our results did not support Cloninger's theory on type I alcoholism, as HA showed no relation to problematic alcohol use in midlife.
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Affiliation(s)
- Daniel Vladimirov
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Solja Niemelä
- Research Unit of Clinical Neurosciences, University of Oulu, Oulu, Finland
| | | | - Leena Ala-Mursula
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Markku Timonen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
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Temperament clusters associate with anxiety disorder comorbidity in depression. J Affect Disord 2018; 236:252-258. [PMID: 29751240 DOI: 10.1016/j.jad.2018.04.084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/24/2018] [Accepted: 04/15/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Individual temperament is associated with psychiatric morbidity and could explain differences in psychiatric comorbidities. We investigated the association of temperament profile clusters with anxiety disorder comorbidity in patients with depression. METHODS We assessed the temperament of 204 specialized care-treated depressed patients with the Temperament and Character Inventory (TCI-R) and their diagnoses with the Mini International Neuropsychiatric Interview. Two-step cluster analysis was used for defining patients' temperament profiles and logistic regression analysis was used for predicting different anxiety disorders for various temperament profiles. RESULTS Four temperament clusters were found: 1) Novelty seekers with highest Novelty Seeking scores (n = 56),2) Persistent with highest Persistence scores (n = 36), 3) Reserved with lowest Novelty Seeking scores (n = 66) and 4) Wearied with highest Harm avoidance, lowest Reward Dependence and lowest Persistence scores (n = 58). After adjusting for clinical variables, panic disorder and/or agoraphobia were predicted by Novelty seekers' temperament profile with odds ratio [OR] = 3.5 (95% confidence interval [CI] = 1.8 - 6.9, p < 0.001), social anxiety disorder was predicted by Wearied temperament profile with OR = 3.4 (95% CI = 1.6 - 7.5, p = 0.002), and generalized anxiety disorder was predicted by Reserved temperament profile with OR = 2.6 (95% CI = 1.2 - 5.3, p = 0.01). LIMITATIONS The patients' temperament profiles were assessed while displaying depressive symptoms, which may have affected results. CONCLUSIONS Temperament clusters with unique dimensional profiles were specifically associated with different anxiety disorders in this study. These results suggest that TCI-R could offer a valuable dimensional method for predicting the risk of anxiety disorders in diverse depressed patients.
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Miniati M, Benvenuti A, Bologna E, Maglio A, Cotugno B, Massimetti G, Calugi S, Mauri M, Dell'Osso L. Mood spectrum comorbidity in patients with anorexia and bulimia nervosa. Eat Weight Disord 2018; 23:305-311. [PMID: 27766498 DOI: 10.1007/s40519-016-0333-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 10/07/2016] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To investigate the presence of mood spectrum signs and symptoms in patients with anorexia nervosa, restricting subtype (AN-R) or bulimia nervosa (BN). METHOD 55 consecutive female patients meeting DSM-IV criteria for eating disorders (EDs) not satisfying DSM-IV criteria for Axis I mood disorders were evaluated with the Lifetime Mood Spectrum Self-Report (MOODS-SR) and the Mini-International Neuropsychiatric Interview (MINI). The MOODS-SR explored the subthreshold comorbidity for mood spectrum symptoms in patients not reaching the threshold for a mood disorder Axis I diagnosis. MOODS-SR included 161 items. Separate factor analyses of MOODS-SR identified 6 'depressive factors' and 9 'manic-hypomanic factors'. RESULTS The mean total score of MOODS-SR was significantly higher in BN than in AN-R patients (97.5 ± 25.4 vs 61.1 ± 38.5, respectively; p = 0.0001). 63.6 % of the sample (n = 35) endorsed the threshold of ≥61 items, with a statistically significant difference between AN-R and BN (39.3 % vs 88.9 %; χ 2 = 14.6; df = 1; p = 0.0001). Patients with BN scored significantly higher than AN-R patients on several MOODS-SR factors: (a) MOODS-SR depressive component: 'depressive mood' (11.2 ± 7.4 vs 16.0 ± 5.8; p < 0.05), 'psychomotor retardation' (5.4 ± 5.6 vs 8.9 ± 3.8; p = 0.003), 'psychotic features' (2.0 ± 1.8 vs 4.1 ± 1.6; p = 0.001), 'neurovegetative symptoms' (5.0 ± 2.6 vs 7.7 ± 1.7; p = 0.001); (b) MOODS-SR manic/hypomanic component: 'psychomotor activation' (4.3 ± 3.6 vs 7.4 ± 3.1; p = 0.002), 'mixed instability' (1.0 ± 1.5 vs 2.0 ± 1.6; p < 0.05), 'mixed irritability' (2.5 ± 1.8 vs 3.7 ± 1.6; p < 0.05), 'inflated self-esteem' (1.1 ± 1.4 vs 2.1 ± 1.6; p < 0.05), and 'wastefulness/recklessness' (1.0 ± 1.4 vs 2.0 ± 1.2; p = 0.009). CONCLUSIONS MOODS-SR identifies subthreshold mood signs/symptoms among patients with AN-R, and BN and with no Axis I comorbidity for mood disorders, and provides a better definition of clinical phenotypes.
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Affiliation(s)
- Mario Miniati
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy.
| | - Antonella Benvenuti
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy
| | - Elena Bologna
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy
| | - Alessandra Maglio
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy
| | - Biagio Cotugno
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy
| | - Simona Calugi
- Alma Mater Studiorum, University of Bologna, Via Zamboni, 33, 40126, Bologna, Italy
| | - Mauro Mauri
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100, Pisa, Italy
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Rotella F, Mannucci E, Gemignani S, Lazzeretti L, Fioravanti G, Ricca V. Emotional eating and temperamental traits in Eating Disorders: A dimensional approach. Psychiatry Res 2018; 264:1-8. [PMID: 29626825 DOI: 10.1016/j.psychres.2018.03.066] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 02/02/2018] [Accepted: 03/22/2018] [Indexed: 12/19/2022]
Abstract
Growing evidence shows that temperamental features and emotional dysregulation are linked to Eating Disorders (EDs). Aim of this study was to explore the possible relationship between temperament and emotional eating (EE) from a dimensional standpoint, and the association of specific temperamental dimensions with overeating triggered by specific emotions. We enrolled 253 women with Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder. Of those, 189 (74.7%), 73 (28.8%), and 80 (31.6%) reported binge eating, purging, or restrictive behaviors, respectively (the categories are not mutually exclusive). Participants completed the Emotional Eating Scale (EES), the Temperament and Character Inventory, the Eating Disorder Examination Questionnaire (EDE-Q) and the Symptom Checklist 90-Revised (SCL-90-R). Higher Persistence scores were found in the Restriction group, while the Binge group reported lower Persistence and higher Novelty Seeking scores. The Purge group showed lower Reward Dependence, Self Directedness and Cooperativeness scores. Patients with Purge also reported lower BMI and higher scores on EDE-Q restriction and eating concern subscales as well as higher scores for all SCL 90-R subscales. Patterns of association between temperamental traits and specific emotions were found in each group. Therefore, some temperamental features could be considered predictors of specific associations between emotions and the tendency to eat.
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Affiliation(s)
- Francesco Rotella
- Psychiatric Unit, Careggi Teaching Hospital, Florence University School of Medicine, Largo Brambilla 3, Florence 50134, Italy.
| | - Edoardo Mannucci
- Diabetes Agency, Careggi Teaching Hospital, Via delle Oblate 4, Florence 50141, Italy
| | - Sara Gemignani
- Department of Health Sciences, Psychiatry Unity, Florence University School of Medicine, Largo Brambilla 3, Florence 50134, Italy
| | - Lisa Lazzeretti
- Department of Health Sciences, Psychiatry Unity, Florence University School of Medicine, Largo Brambilla 3, Florence 50134, Italy
| | - Giulia Fioravanti
- Department of Health Sciences, Psychology and Psychiatry Unit, University of Florence, via di San Salvi 12, Florence 50100, Italy
| | - Valdo Ricca
- Department of Health Sciences, Psychiatry Unity, Florence University School of Medicine, Largo Brambilla 3, Florence 50134, Italy
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The relationship between emotion regulation strategies, personality traits and skin picking behaviours in a non-clinical sample of Polish adults. Psychiatry Res 2018; 264:67-75. [PMID: 29627699 DOI: 10.1016/j.psychres.2018.03.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 03/11/2018] [Accepted: 03/20/2018] [Indexed: 12/15/2022]
Abstract
Although skin-picking is a relatively common behaviour, data concerning factors which underlie skin-picking severity and functional impairment caused by picking are still limited. In the present study we examined whether some emotion regulation strategies (cognitive reappraisal and expressive suppression) and personality features influence skin-picking in a university sample; the moderating role of personality traits in the relationship between emotion regulation strategies and skin-picking was also considered. A total sample of 252 adults (mean age 24.03; SD = 5.66) completed the Skin-Picking Scale-Revised, Temperament and Character Inventory and Emotion Regulation Questionnaire. The linear regression analyses indicated that the use of cognitive reappraisal as emotion regulation strategy decrease skin-picking severity. Reduced novelty seeking and reduced self-directedness were identified as significant predictors of skin-picking severity, whereas decreased self-directedness and elevated cooperativeness predicted functional impairment caused by skin-picking. Further moderation analysis revealed that cognitive reappraisal decreases skin-picking severity only among individuals with low and moderate novelty seeking, however, not among those with high novelty seeking. These results indicate that emotion regulation strategies and specific personality traits are important factors associated with skin-picking behaviours in a university sample. Further research is needed to establish the link between emotion regulation strategies and personality traits in clinical sample.
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BDNF and NRG1 polymorphisms and temperament in selective serotonin reuptake inhibitor-treated patients with major depression. Acta Neuropsychiatr 2018; 30:168-174. [PMID: 29310728 DOI: 10.1017/neu.2017.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE We investigated the separate effects of and possible interactions between the functional polymorphisms of brain-derived neurotrophic factor (BDNF) rs11030101, BDNF rs61888800, and neuregulin-1 (NRG1) rs3924999 and NRG1 rs6994992 on change of temperament scores in a clinical sample of subjects with major depression (MDD), who received selective serotonin reuptake inhibitor treatment for a period of 6 weeks. METHODS The study population consisted of 98 Finnish individuals with MDD. They were assessed by the 107-item Temperament and Character Inventory temperament questionnaire (version IX) and the Montgomery-Åsberg Depression Rating Scale (MADRS). In general linear univariate models (GLM) for novelty seeking (NS) or reward dependence (RD) change age, gender, MADRS score change and BDNF and NRG1 genotypes were used as explaining explanatory variables. RESULTS Mean comparisons between corresponding temperament dimensions and genotypes showed significant differences between NS change and BDNF rs61888800 T-carrying status (mean difference: GG 0.30, GT/TT 2.47, p=0.022, t-test) and between RD change and NRG1 rs3924999 A-carrying status (mean difference: GG 1.21, GA/AA -0.33, p=0.003). In GLM models for NS change the significant predictors comprised BDNF rs61888800 T-carrying status, age and MADRS score change (model 1), and additionally NRG1 rs6994992 T-carrying status (model 2). For RD change the predictors included NRG1 rs3924999 A-carrying status, age and MADRS score change (model 1) and additionally gender (model 2). CONCLUSION According to the current results both BDNF and NRG1 are associated with temperament traits during depression. These results warrant further studies regarding the impact of this association on depression recovery.
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Early vulnerabilities for psychiatric disorders in elementary schoolchildren from four Brazilian regions. Soc Psychiatry Psychiatr Epidemiol 2018; 53:477-486. [PMID: 29511791 DOI: 10.1007/s00127-018-1503-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 02/28/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE The purpose of the study is to identify early vulnerabilities for psychiatric disorders among Brazilian elementary school children, controlling for familial and community adversities. METHODS This is a cross-sectional study examining the association between child psychiatric disorders and potential early vulnerabilities (disability, low intellectual quotient, and negative dimensions of the temperament trait self-directedness (low resourcefulness, low purposefulness, low enlightened second nature), controlling for the potential confounders: familial and community adversities. SAMPLE Four probabilistic samples of second-to-sixth grade students from public schools in four towns from different Brazilian regions (N = 1620). The following instruments were applied: the K-SADS-PL (to assess child/adolescent psychiatric disorders); the Ten-Question Screen (to measure child disability); three structured questions used as proxy of self-directedness; and the reduced version of the WISC-III to measure IQ. To evaluate familial/community adversities: Self-Report Questionnaire-SRQ-20 (to assess maternal/primary caretaker anxiety/depression); questions derived from structured questionnaires (to measure child abuse, marital physical violence, neighborhood violence); Brazilian Association of Research Companies questionnaire (to evaluate poverty/socioeconomic status). Trained psychologists interviewed mothers/primary caretakers and evaluated children/adolescents individually. RESULTS A final logistic regression model showed that children/adolescents with low resourcefulness, low purposefulness, low enlightened second nature, lower IQ and disability were more likely to present any child psychiatric disorders. CONCLUSION Early vulnerabilities such as low IQ, presence of disability, and dimensions of temperament were associated with psychiatric disorders among Brazilian elementary school children, after controlling for familial and ecological confounders. These early vulnerabilities should be considered in mental health prevention/intervention programs in low-middle-income countries like Brazil.
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Nogueira BS, Fraguas R, Benseñor IM, Lotufo PA, Brunoni AR. Temperament and character traits in major depressive disorder: a case control study. SAO PAULO MED J 2017; 135:469-474. [PMID: 28977097 PMCID: PMC10027245 DOI: 10.1590/1516-3180.2017.0063250517] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 05/25/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Patients with major depressive disorder (MDD) have distinct personality traits, compared with control subjects, although the role of anxiety and positive and negative affects in this finding is unclear. DESIGN AND SETTING A case-control study enrolling 103 antidepressant-free depressed patients and 103 age and gender-matched controls was conducted at the University Hospital, University of São Paulo. METHODS The self-reported scales of the Positive and Negative Affect Schedule (PANAS), State-Trait Anxiety Inventory (STAI) and Cloninger's Temperament and Character Inventory (TCI) were applied. Temperament and character traits were compared between groups using multivariate and bivariate analyses of variance (MANOVA and ANOVA). The influence of anxiety and affect was further investigated using ANOVA and mediation analyses. RESULTS Depressed patients presented higher harm avoidance and lower self-directedness scores than controls. After adjustment for anxiety trait, harm avoidance was no longer significantly different between groups. Mediation analysis revealed that the anxiety trait, but not state-anxiety or affect, fully mediated the influence of group (depressed versus control subjects) on harm avoidance. CONCLUSIONS Our findings confirm that depressed patients present personality traits distinct from those of controls and suggest that MDD is not directly associated with harm avoidance, but that this effect is fully mediated through the anxiety trait.
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Affiliation(s)
- Barbara Schwair Nogueira
- MD, MSc, PhD. Psychologist, Hospital Universitário, Universidade de São Paulo (HU/USP), Center for Clinical and Epidemiological Research & Interdisciplinary Center for Applied Neuromodulation (Centro Interdisciplinar de Neuromodulação Aplicada, CINA), São Paulo (SP), Brazil.
| | - Renerio Fraguas
- MD, PhD. Associate Professor, Department and Institute of Psychiatry, Universidade de São Paulo (USP), Center for Clinical and Epidemiological Research & Interdisciplinary Center for Applied Neuromodulation (Centro Interdisciplinar de Neuromodulação Aplicada, CINA), São Paulo (SP), Brazil.
| | - Isabela Martins Benseñor
- MD, PhD. Associate Professor, Hospital Universitário, Universidade de São Paulo (HU/USP), Center for Clinical and Epidemiological Research & Interdisciplinary Center for Applied Neuromodulation (Centro Interdisciplinar de Neuromodulação Aplicada, CINA), São Paulo (SP), Brazil.
| | - Paulo Andrade Lotufo
- MD, DrPH. Professor, Hospital Universitário, Universidade de São Paulo (HU/USP), Center for Clinical and Epidemiological Research & Interdisciplinary Center for Applied Neuromodulation (Centro Interdisciplinar de Neuromodulação Aplicada, CINA), São Paulo (SP), Brazil.
| | - Andre Russowsky Brunoni
- MD. PhD. Attending Physician, Department and Institute of Psychiatry, Faculdade de Medicina, Hospital Universitário, Universidade de São Paulo (HU/USP), Center for Clinical and Epidemiological Research & Interdisciplinary Center for Applied Neuromodulation (Centro Interdisciplinar de Neuromodulação Aplicada, CINA), Service of Interdisciplinary Neuromodulation (SIN), Laboratory of Neurosciences (Laboratório de Neurociências, LIM-27), São Paulo, Brazil.
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Shame, trauma, temperament and psychopathology: Construct validity of the Experience of Shame Scale. Psychiatry Res 2016; 246:62-69. [PMID: 27664547 DOI: 10.1016/j.psychres.2016.09.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 08/09/2016] [Accepted: 09/13/2016] [Indexed: 11/23/2022]
Abstract
Although Experience of Shame Scale (ESS) is used in clinical research and it covers psychiatrically relevant dimensions of chronic shame, characterological (CS), behavioral (BS) and bodily (BoS) respectively, its factor structures were not confirmed on clinical sample. The goals of our research were to examine the factor structure of the Hungarian version of ESS, in addition, to analyze the associations between factors of ESS and different types of predictors, such as clinical status, gender, age, school years, early abuse history, general psychopathology (GSI), and temperament dimensions by using a series of confirmatory factor analyses (CFA) with covariates in a large clinical and matched healthy sample. Psychiatric inpatients (N=148) and healthy control subjects (N=148) participated in this cross-sectional questionnaire study. In both samples, the degree of fit was adequate. The final CFA with covariates model showed significant and positive associations between CS and clinical status and education respectively, between CS, BS, BoS and frequency of verbal abuse, between CS and BoS and GSI and between CS and BS and harm avoidance and in addition we found negative associations between each of the shame factors and age. Our results support the psychiatric validity of the ESS construct.
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Hu W, Ma Z, Di S, Jiang S, Li Y, Fan C, Yang Y, Wang D. Snapshot: implications for melatonin in endoplasmic reticulum homeostasis. Br J Pharmacol 2016; 173:3431-3442. [PMID: 27759160 DOI: 10.1111/bph.13651] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/27/2016] [Accepted: 10/03/2016] [Indexed: 12/13/2022] Open
Abstract
The endoplasmic reticulum (ER) is an important intracellular membranous organelle. Previous studies have demonstrated that the ER is responsible for protein folding and trafficking, lipid synthesis and the maintenance of calcium homeostasis. Interestingly, the morphology and structure of the ER were recently found to be important. Melatonin is a hormone that anticipates the daily onset of darkness in mammals, and it is well known that melatonin acts as an antioxidant by scavenging free radicals and increasing the activity of antioxidant enzymes in the body. Notably, the existing evidence demonstrates that melatonin is involved in ER homeostasis, particularly in the morphology of the ER, indicating a potential protective role of melatonin. This review discusses the existing knowledge regarding the implications for the involvement of melatonin in ER homeostasis.
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Affiliation(s)
- Wei Hu
- Department of Thoracic and Cardiovascular Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.,Department of Biomedical Engineering, The Fourth Military Medical University, Xi'an, China
| | - Zhiqiang Ma
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Shouyin Di
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Shuai Jiang
- Department of Aerospace Medicine, The Fourth Military Medical University, Xi'an, China
| | - Yue Li
- Department of Biomedical Engineering, The Fourth Military Medical University, Xi'an, China
| | - Chongxi Fan
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Yang Yang
- Department of Thoracic and Cardiovascular Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.,Department of Biomedical Engineering, The Fourth Military Medical University, Xi'an, China
| | - Dongjin Wang
- Department of Thoracic and Cardiovascular Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
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Knežević G, Lazarević LB, Bosnjak M, Purić D, Petrović B, Teovanović P, Opačić G, Bodroža B. Towards a personality model encompassing a Disintegration factor separate from the Big Five traits: A meta-analysis of the empirical evidence. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.02.044] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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31
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Farstad SM, McGeown LM, von Ranson KM. Eating disorders and personality, 2004–2016: A systematic review and meta-analysis. Clin Psychol Rev 2016. [DOI: 10.1016/j.cpr.2016.04.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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32
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Amianto F, Bertorello A, Migliore F, Abbate-Daga G, Fassino S. Alexithymia in anorexia and bulimia: Ubiquitous and primary trait? COGENT PSYCHOLOGY 2016. [DOI: 10.1080/23311908.2016.1185994] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- F. Amianto
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
| | - A. Bertorello
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
| | - F. Migliore
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
| | - G. Abbate-Daga
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
| | - S. Fassino
- Neuroscience Department, Psychiatry Section, University of Turin, Psychiatric Clinic, V. Cherasco 11, 10126 Turin, Italy
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A meta-analysis of temperament and character dimensions in patients with mood disorders: Comparison to healthy controls and unaffected siblings. J Affect Disord 2016; 194:84-97. [PMID: 26803780 DOI: 10.1016/j.jad.2015.12.077] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 12/30/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Cloninger's psychobiological model of personality has been extensively applied to subjects affected by mood disorders (MOOD). However, most studies are widely heterogeneous in terms of sample size, methods of assessment, and selection of participants. METHODS We conducted a systematic review of literature and a random effects meta-analysis of studies comparing at least two of the following groups: (a) adults with a primary MOOD diagnosis (Bipolar Disorder (BP) or major depressive disorder (MDD)), (b) their unaffected siblings (SIB) or (c) healthy subjects (HS), and reporting quantitative results from the Tridimensional Personality Questionnaire (TPQ) or the Temperament and Character Inventory (TCI). Subgroup, sensitivity and meta-regression analyses were also conducted. RESULTS High Harm Avoidance and low Self-Directedness were consistently associated with MOOD and SIB samples. BP was characterized by higher scores in Novelty Seeking and Self-Transcendence than HS, SIB and MDD. Age seemed to have a negative effect on Novelty Seeking and a positive effect on Harm Avoidance, Cooperativeness and Self-Transcendence. An euthymic mood state was associated with reduced Harm Avoidance, but increased Reward Dependence, Self-Directedness and Cooperativeness. LIMITATIONS The quality of the included studies varied and was relatively low. Moreover, publication bias and heterogeneity in the distribution of effect sizes may also have limited our results. CONCLUSION High Harm Avoidance and Low Self-Directedness may be trait markers for MOOD in general, while high Novelty Seeking and high Self-Transcendence may be specific to BP. Future studies are needed to disentangle the state-trait effect of each personality dimension.
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Hu W, Ma Z, Jiang S, Fan C, Deng C, Yan X, Di S, Lv J, Reiter RJ, Yang Y. Melatonin: the dawning of a treatment for fibrosis? J Pineal Res 2016; 60:121-31. [PMID: 26680689 DOI: 10.1111/jpi.12302] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 12/11/2015] [Indexed: 12/28/2022]
Abstract
Fibrosis is a common occurrence following organ injury and failure. To date, there is no effective treatment for this condition. Melatonin targets numerous molecular pathways, a consequence of its antioxidant and anti-inflammatory actions that reduce excessive fibrosis. Herein, we review the multiple protective effects of melatonin against fibrosis. There exist four major phases of the fibrogenic response including primary injury to the organ, activation of effector cells, the elaboration of extracellular matrix (ECM) and dynamic deposition. Melatonin regulates each of these phases. Additionally, melatonin reduces fibrosis levels in numerous organs. Melatonin exhibits its anti-fibrosis effects in heart, liver, lung, kidney, and other organs. In addition, adhesions which occur following surgical procedures are also inhibited by melatonin. The information reviewed here should be significant to understanding the protective role of melatonin against fibrosis, contribute to the design of further experimental studies related to melatonin and the fibrotic response and shed light on a potential treatment for fibrosis.
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Affiliation(s)
- Wei Hu
- Department of Biomedical Engineering, The Fourth Military Medical University, Xi'an, China
- Department of General Surgery, Beidaihe Sanatorium, Beijing Military Area Command, Qinhuangdao, China
| | - Zhiqiang Ma
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Shuai Jiang
- Department of Aerospace Medicine, The Fourth Military Medical University, Xi'an, China
| | - Chongxi Fan
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Chao Deng
- Department of Cardiovascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Xiaolong Yan
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Shouyin Di
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Jianjun Lv
- Department of Biomedical Engineering, The Fourth Military Medical University, Xi'an, China
| | - Russel J Reiter
- Department of Cellular and Structural Biology, UT Health Science Center, San Antonio, TX, USA
| | - Yang Yang
- Department of Biomedical Engineering, The Fourth Military Medical University, Xi'an, China
- Department of General Surgery, Beidaihe Sanatorium, Beijing Military Area Command, Qinhuangdao, China
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Mota NR, Rovaris DL, Kappel DB, Picon FA, Vitola ES, Salgado CAI, Karam RG, Rohde LA, Grevet EH, Bau CHD. NCAM1-TTC12-ANKK1-DRD2 gene cluster and the clinical and genetic heterogeneity of adults with ADHD. Am J Med Genet B Neuropsychiatr Genet 2015; 168:433-444. [PMID: 25989041 DOI: 10.1002/ajmg.b.32317] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 04/07/2015] [Indexed: 12/23/2022]
Abstract
Dysfunctions of the dopaminergic system have been implicated on the etiology of Attention Deficit/Hyperactivity Disorder (ADHD). Meta-analyses addressing the association of the dopamine receptor D2 (DRD2) gene and ADHD were inconclusive due to excessive heterogeneity across studies. Both the great phenotypic heterogeneity of ADHD and the complexity of the genomic region where DRD2 is located could contribute to the inconsistent findings. Most previous DRD2 studies focused on the well-known Taq1A (rs1800497) SNP, which is actually placed in a neighbor gene (ANKK1). These two genes, together with NCAM1 and TTC12, form the NTAD gene cluster on Chr11q22-23. In order to address the reasons for the high heterogeneity previously reported on DRD2 effects on ADHD, this study investigates the role of NTAD variants on ADHD susceptibility in adults and on the modulation of comorbidity and personality profiles in these patients. Functional polymorphisms from NTAD were analyzed, both individually and in haplotypes, on a sample of 520 adults with ADHD and 630 non-ADHD controls. No direct association of NTAD variants with ADHD susceptibility itself was observed. However, different NTAD polymorphisms and haplotypes were associated to various phenotypes relevant to the clinical heterogeneity of ADHD, including Major Depressive Disorder, Generalized Anxiety Disorder, and Harm Avoidance and Persistence temperament scores. Therefore, these findings represent a possible explanation for the multiple conflicting findings regarding polymorphisms in this genomic region in psychiatry. The NTAD cluster may comprise a variety of independent molecular influences on various brain and behavior characteristics eventually associated with ADHD comorbidities and personality traits. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Nina R Mota
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,ADHD Outpatient Program-Adult Division, Hospital de Clínicas, de Porto Alegre, Porto Alegre, Brazil
| | - Diego L Rovaris
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,ADHD Outpatient Program-Adult Division, Hospital de Clínicas, de Porto Alegre, Porto Alegre, Brazil
| | - Djenifer B Kappel
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,ADHD Outpatient Program-Adult Division, Hospital de Clínicas, de Porto Alegre, Porto Alegre, Brazil
| | - Felipe A Picon
- ADHD Outpatient Program-Adult Division, Hospital de Clínicas, de Porto Alegre, Porto Alegre, Brazil
| | - Eduardo S Vitola
- ADHD Outpatient Program-Adult Division, Hospital de Clínicas, de Porto Alegre, Porto Alegre, Brazil
| | - Carlos A I Salgado
- ADHD Outpatient Program-Adult Division, Hospital de Clínicas, de Porto Alegre, Porto Alegre, Brazil
| | - Rafael G Karam
- ADHD Outpatient Program-Adult Division, Hospital de Clínicas, de Porto Alegre, Porto Alegre, Brazil
| | - Luis A Rohde
- ADHD Outpatient Program-Adult Division, Hospital de Clínicas, de Porto Alegre, Porto Alegre, Brazil.,Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Eugenio H Grevet
- ADHD Outpatient Program-Adult Division, Hospital de Clínicas, de Porto Alegre, Porto Alegre, Brazil.,Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Claiton H D Bau
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,ADHD Outpatient Program-Adult Division, Hospital de Clínicas, de Porto Alegre, Porto Alegre, Brazil
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von Hausswolff-Juhlin Y, Brooks SJ, Larsson M. The neurobiology of eating disorders--a clinical perspective. Acta Psychiatr Scand 2015; 131:244-55. [PMID: 25223374 DOI: 10.1111/acps.12335] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To provide a neurobiological basis of eating disorders for clinicians and to enlighten how comparing neurobiology and eating disorders with neurobiology of other psychiatric illnesses can improve treatment protocols. METHOD A selective review on the neurobiology of eating disorders. The article focuses on clinical research on humans with consideration of the anatomical, neural, and molecular basis of eating disorders. RESULTS The neurobiology of people with eating disorders is altered. Many of the neurobiological regions, receptors, and chemical substrates that are affected in other mental illnesses also play an important role in eating disorders. More knowledge about the neurobiological overlap between eating disorders and other psychiatric populations will help when developing treatment protocols not the least regarding that comorbidity is common in patients with EDs. CONCLUSION Knowledge about the underlying neurobiology of eating disorders will improve treatment intervention and will benefit from comparisons with other mental illnesses and their treatments.
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Affiliation(s)
- Y von Hausswolff-Juhlin
- Center for Psychiatry Research, Karolinska Institute, Stockholm, Sweden; Stockholm Centre for Eating Disorders, Stockholm, Sweden
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Peritogiannis V. Sensation/novelty seeking in psychotic disorders: A review of the literature. World J Psychiatry 2015; 5:79-87. [PMID: 25815257 PMCID: PMC4369552 DOI: 10.5498/wjp.v5.i1.79] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 12/31/2014] [Accepted: 01/19/2015] [Indexed: 02/05/2023] Open
Abstract
The evaluation of personality traits is important for the better understanding of the person suffering from psychosis and for treatment individualization. However literature on patients’ personality and character in such disorders is limited. The aim of this review was to summarize the literature on sensation/novelty seeking (SNS), a trait which is biologically based and highly heritable and is associated with dopamine activity, and refers to a person’s tendency to seek varied, novel, complex, and intense sensations and experiences. A total of 38 studies were included in this review, involving 2808 patients and 2039 healthy controls. There is consistent evidence that this trait is independently associated with alcohol and substance abuse in patients with schizophrenia and related disorders. The estimation of SNS would help clinicians to identify patients at risk for abuse. There is also some evidence that higher SNS levels may relate to medication non-adherence and seem to increase the risk of patients’ aggressive and violent behavior, but studies are scarce. SNS was found not to be related to suicidality, whereas in the fields of patients’ quality of life and psychopathology results are contradictory, but most studies show no possible association. Several studies suggest that SNS is lower in psychotic patients compared to controls, whereas most yield no differences. The evidence for this trait as a potential endophenotype of schizophrenia is weak. SNS may be implicated in psychotic disorders’ course and prognosis in several ways and should be always inquired for. This trait can be reliably measured with the use of easily applicable self-rated instruments, and patients’ accounts could inform clinicians when planning management and delivering individualized treatment.
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Rotella F, Fioravanti G, Godini L, Mannucci E, Faravelli C, Ricca V. Temperament and emotional eating: a crucial relationship in eating disorders. Psychiatry Res 2015; 225:452-7. [PMID: 25537489 DOI: 10.1016/j.psychres.2014.11.068] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 08/28/2014] [Accepted: 11/29/2014] [Indexed: 11/28/2022]
Abstract
Specific personality traits are related to Eating Disorders (EDs) specific and general psychopathology. Recent studies suggested that Emotional Eating (EE) is a common dimension in all EDs, irrespective of binge eating. The present study was aimed to explore the relationship of temperamental features with EE and eating symptomatology in a sample of EDs patients, adjusting for general psychopathology. One hundred and sixty six female patients were enrolled at the Eating Disorders Outpatient Clinic of the Careggi Teaching-Hospital of Florence. Participants completed the emotional eating scale, the temperament and character inventory, the eating disorder examination questionnaire and the symptom checklist 90-revised. Novelty seeking and self directedness showed significant correlations with EE after adjustment for general psychopathology. Patients with binge eating displayed significant associations between EE and novelty seeking and self directedness. Among patients without binge eating, no significant correlation between EE and temperamental features was observed. Specific temperamental features are associated to EE in EDs. A clear, different pattern of association in patients with different eating attitudes and behavior was found. Considering that treatments of EDs are largely based on psychotherapeutic interventions, focused on emotions and cognitions, the present data provide some hints which could be helpful for the development of more appropriate psychotherapeutic strategies.
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Affiliation(s)
- Francesco Rotella
- Psychiatric Unit, Careggi Teaching Hospital, Florence University School of Medicine, Largo Brambilla 3, 50134 Florence, Italy.
| | - Giulia Fioravanti
- Department of Health Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy.
| | - Lucia Godini
- Psychiatric Unit, Careggi Teaching Hospital, Florence University School of Medicine, Largo Brambilla 3, 50134 Florence, Italy.
| | - Edoardo Mannucci
- Diabetes Agency, Careggi Teaching Hospital, Via delle Oblate 4, 50141 Florence, Italy.
| | - Carlo Faravelli
- Department of Health Sciences, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy.
| | - Valdo Ricca
- Psychiatric Unit, Careggi Teaching Hospital, Florence University School of Medicine, Largo Brambilla 3, 50134 Florence, Italy.
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Atiye M, Miettunen J, Raevuori-Helkamaa A. A meta-analysis of temperament in eating disorders. EUROPEAN EATING DISORDERS REVIEW 2014; 23:89-99. [PMID: 25546554 DOI: 10.1002/erv.2342] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 12/03/2014] [Accepted: 12/08/2014] [Indexed: 11/09/2022]
Abstract
Although suggested as an important contributor to the development and maintenance of eating disorders, temperament has not previously been studied adopting a meta-analytical approach. We therefore pooled data (N = 14 studies; N = 3315 cases, N = 3395 controls) on Cloninger's temperament traits (novelty seeking, harm avoidance, reward dependence and persistence) in anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and eating disorders not otherwise specified. Persistence was significantly higher than in the controls in all eating disorders except for BED the highest levels being observed in AN. Correspondingly, the highest effect sizes for harm avoidance were seen in AN. Novelty seeking was significantly elevated relative to the controls only in BN. Harm avoidance was significantly lower, and reward dependence was significantly higher in individuals who had recovered from AN than in those who remained ill. Future studies with a longitudinal design are needed to explore the temporal relationships between eating disorders and temperament traits.
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Affiliation(s)
- Minna Atiye
- Hjelt Institute, Department of Public Health, University of Helsinki, Finland
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Aukst-Margetić B, Jakšić N, Boričević Maršanić V, Jakovljević M. Harm avoidance moderates the relationship between internalized stigma and depressive symptoms in patients with schizophrenia. Psychiatry Res 2014; 219:92-4. [PMID: 24857565 DOI: 10.1016/j.psychres.2014.05.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 04/28/2014] [Accepted: 05/05/2014] [Indexed: 11/30/2022]
Abstract
This study investigated the associations between internalized stigma, depressive symptoms, and temperament dimension Harm avoidance. One hundred and seventeen stable outpatients with schizophrenia completed a battery of self-report instruments. Internalized stigma was significantly positively related to depressive symptoms, while Harm avoidance moderated the internalized stigma-depressive symptoms relationship.
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Affiliation(s)
- Branka Aukst-Margetić
- Department of Psychiatry, University Hospital Center Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia.
| | - Nenad Jakšić
- Department of Psychiatry, University Hospital Center Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia
| | | | - Miro Jakovljević
- Department of Psychiatry, University Hospital Center Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia
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O'Driscoll C, Laing J, Mason O. Cognitive emotion regulation strategies, alexithymia and dissociation in schizophrenia, a review and meta-analysis. Clin Psychol Rev 2014; 34:482-95. [DOI: 10.1016/j.cpr.2014.07.002] [Citation(s) in RCA: 130] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 07/14/2014] [Accepted: 07/17/2014] [Indexed: 01/11/2023]
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Buchman AS, Yu L, Wilson RS, Shulman JM, Boyle PA, Bennett DA. Harm avoidance is associated with progression of parkinsonism in community-dwelling older adults: a prospective cohort study. BMC Geriatr 2014; 14:54. [PMID: 24754876 PMCID: PMC4022545 DOI: 10.1186/1471-2318-14-54] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 04/14/2014] [Indexed: 11/26/2022] Open
Abstract
Background We tested the hypothesis that harm avoidance, a trait associated with behavioral inhibition, is associated with the rate of change in parkinsonism in older adults. Methods At baseline harm avoidance was assessed with a standard self-report instrument in 969 older people without dementia participating in the Rush Memory and Aging Project, a longitudinal community-based cohort study. Parkinsonism was assessed annually with a modified version of the motor section of the Unified Parkinson’s Disease Rating Scale (mUPDRS). Results Average follow-up was 5 years. A linear mixed-effects model controlling for age, sex and education showed that for an average participant (female, 80 years old at baseline, with 14 years of education and a harm avoidance score of 10), the overall severity of parkinsonism increased by about 0.05 unit/ year (Estimate, 0.054, S.E., 0.007, p <0.001) and that the level of harm avoidance was associated with the progression of parkinsonism (Estimate, 0.004, S.E., 0.001, p <0.001). Thus, for an average participant, every 6 point (~1 SD) increase in harm avoidance score at baseline, the rate of progression of parkinsonism increased about 50% compared to an individual with an average harm avoidance score. This amount of change in parkinsonism over the course of the study was associated with about a 5% increased risk of death. The association between harm avoidance and progression of parkinsonism persisted when controlling for cognitive function, depressive symptoms, loneliness, neuroticism, late-life cognitive, social and physical activities and chronic health conditions. Conclusion A higher level of the harm avoidance trait is associated with a more rapid progression of parkinsonism in older adults.
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Affiliation(s)
- Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
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Linna MS, Raevuori A, Haukka J, Suvisaari JM, Suokas JT, Gissler M. Reproductive health outcomes in eating disorders. Int J Eat Disord 2013; 46:826-33. [PMID: 23996114 DOI: 10.1002/eat.22179] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 07/16/2013] [Accepted: 07/20/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Eating disorders are common psychiatric disorders in women at childbearing age. Previous research suggests that eating disorders are associated with fertility problems, unplanned pregnancies, and increased risk of induced abortions and miscarriages. The purpose of this study was to assess how eating disorders are related to reproductive health outcomes in a representative patient population. METHOD Female patients (N = 2,257) treated at the eating disorder clinic of Helsinki University Central Hospital during 1995-2010 were compared with matched controls identified from the Central Population Register (N = 9,028). Patients had been diagnosed (ICD-10) with anorexia nervosa (AN), atypical AN, bulimia nervosa (BN), atypical BN, or binge eating disorder (BED, according to DSM-IV research criteria). Register-based data on number of children, pregnancies, childbirths, induced abortions, miscarriages, and infertility treatments were used to measure reproductive health outcomes. RESULTS Patients were more likely to be childless than controls [odds ratio (OR) 1.86; 95% confidence interval (CI) 1.62-2.13, p < .001]. Pregnancy and childbirth rates were lower among patients than among controls. BN was associated with increased risk of induced abortion compared to controls (OR 1.85; 95% CI 1.43-2.38, p < .001), whereas BED was associated with elevated risk of miscarriage (OR 3.18; 95% CI 1.52-6.66, p = .002). DISCUSSION Reproductive health outcomes are compromised in women with a history of eating disorders across all eating disorder types. Our findings emphasize the importance of reproductive health counseling and monitoring among women with eating disorders.
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Affiliation(s)
- Milla S Linna
- Hjelt Institute, Department of Public Health, University of Helsinki, Finland
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Abstract
PURPOSE OF REVIEW To systematize new neurobiological findings on the cause and treatment of eating disorders. RECENT FINDINGS The conceptual framework of the cause of eating disorders has undergone great changes in the past decades. Recently, the National Institute of Mental Health proposed a new set of criteria for research purposes--the Research Domain Criteria (RDoC). We aim to structure this study as much as possible using these constructs across biological units of analysis, summarizing new findings. Brain imaging techniques have become sophisticated in identifying brain circuits related to illness behaviour and to fundamental traits such as reward and social processing. Genetic studies have moved from candidate gene studies onto genome-wide association studies; however, the field needs to cooperate to collect larger samples in order to benefit from this approach. Hormonal changes as the results of starvation or as underlying factors for behavioural changes still receive attention in both animal and human studies. Advances made in neuropsychology show problems in cognition (set shifting and central coherence) and in other RDoC domains. Some of these findings have been translated into treatment. SUMMARY New biological models are being developed which explain causal and maintaining factors. The RDoC construct may be used to systematize these findings.
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Vaz-Leal FJ, Rodríguez-Santos L, García-Herráiz MA, Chimpén-López CA, Rojo-Moreno L, Beato-Fernández L, Ramos-Fuentes MI. The role of depression and impulsivity in the psychopathology of bulimia nervosa. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2013; 7:25-31. [PMID: 23972724 DOI: 10.1016/j.rpsm.2013.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 06/18/2013] [Accepted: 06/20/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The study aimed to analyze the role of depression and impulsivity in the psychopathology of bulimia nervosa (BN). MATERIALS AND METHODS Seventy female patients with DSM-IV BN, purging subtype, were assessed for eating-related symptoms, body dissatisfaction, affective symptoms, impulsivity, and personality traits. Factor analysis and structural equation modeling methods were used for statistical analysis. RESULTS BN appeared as a condition which incorporated 5 general dimensions: a) binge eating and compensatory behaviours; b) restrictive eating; c) body dissatisfaction; d) dissocial personality traits; and e) a cluster of features which was called «emotional instability» The 5 obtained dimensions can be grouped into 2 basic factors: body dissatisfaction/eating behaviour and personality traits/psychopathology. The first one contains the clinical items used for the definition of BN as a clinical condition in the DSM-V and the International Classification of Diseases 10, and reflects the morphology and the severity of the eating-related symptoms. The second dimension includes a cluster of symptoms (depressive symptoms, impulsivity, and borderline, self-defeating and dissocial personality traits) which could be regarded as the «psychopathological core» of BN and may be able to condition the course and the prognosis of BN.
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Affiliation(s)
- Francisco J Vaz-Leal
- Facultad de Medicina, Universidad de Extremadura/Unidad de Trastornos de la Conducta Alimentaria, Complejo Hospitalario Universitario, Servicio Extremeño de Salud, Badajoz, España.
| | - Laura Rodríguez-Santos
- Facultad de Medicina, Universidad de Extremadura/Unidad de Trastornos de la Conducta Alimentaria, Complejo Hospitalario Universitario, Servicio Extremeño de Salud, Badajoz, España
| | - M Angustias García-Herráiz
- Facultad de Medicina, Universidad de Extremadura/Unidad de Trastornos de la Conducta Alimentaria, Complejo Hospitalario Universitario, Servicio Extremeño de Salud, Badajoz, España
| | - Carlos A Chimpén-López
- Facultad de Medicina, Universidad de Extremadura/Unidad de Trastornos de la Conducta Alimentaria, Complejo Hospitalario Universitario, Servicio Extremeño de Salud, Badajoz, España
| | - Luís Rojo-Moreno
- Facultad de Medicina, Universidad de Valencia/Unidad de Trastornos de la Conducta Alimentaria, Hospital La Fe, Valencia, España
| | - Luís Beato-Fernández
- Facultad de Medicina, Unidad de Trastornos de la Conducta Alimentaria, Hospital General de Ciudad Real, Universidad de Castilla-La Mancha, Ciudad Real, España
| | - María Isabel Ramos-Fuentes
- Facultad de Medicina, Universidad de Extremadura/Unidad de Trastornos de la Conducta Alimentaria, Complejo Hospitalario Universitario, Servicio Extremeño de Salud, Badajoz, España
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The influence of the Val158Met catechol-O-methyltransferase polymorphism on the personality traits of bipolar patients. PLoS One 2013; 8:e62900. [PMID: 23646156 PMCID: PMC3639910 DOI: 10.1371/journal.pone.0062900] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 03/26/2013] [Indexed: 01/13/2023] Open
Abstract
Introduction Certain personality traits and genetic polymorphisms are contributing factors to bipolar disorder and its symptomatology, and in turn, this syndrome influences personality. The aim of the present study is to compare the personality traits of euthymic bipolar patients with healthy controls and to investigate the effect of the catechol-O-methyltransferase (COMT) Val158Met genotype on those traits. We recruited thirty seven bipolar I patients in euthymic state following a manic episode and thirty healthy controls and evaluated their personality by means of the Cloninger’s Temperament and Character Inventory (version TCI-R-140). We assessed the influence of the polymorphism Val158Met in the COMT gene on the personality of these patients. The patients scored higher than controls in harm avoidance (61.3±12.5 vs. 55.3±8.1) and self-transcendence (45.3±12.8 vs. 32.7±8.2) and scored lower than controls in self-directedness (68.8±13.3 vs. 79.3±8.1), cooperativeness (77.1±9.1 vs. 83.9±6.5) and persistence (60.4±15.1 vs. 67.1±8.9). The novelty seeking dimension associates with the Val158Met COMT genotype; patients with the low catabolic activity genotype, Met/Met, show a higher score than those with the high catabolic activity genotype, Val/Val. Conclusions Suffering from bipolar disorder could have an impact on personality. A greater value in harm avoidance may be a genetic marker for a vulnerability to the development of a psychiatric disorder, but not bipolar disorder particularly, while a low value in persistence may characterize affective disorders or a subgroup of bipolar patients. The association between novelty seeking scores and COMT genotype may be linked with the role dopamine plays in the brain’s reward circuits.
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Tuominen L, Salo J, Hirvonen J, Någren K, Laine P, Melartin T, Isometsä E, Viikari J, Cloninger CR, Raitakari O, Hietala J, Keltikangas-Järvinen L. Temperament, character and serotonin activity in the human brain: a positron emission tomography study based on a general population cohort. Psychol Med 2013; 43:881-894. [PMID: 22850434 DOI: 10.1017/s003329171200164x] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The psychobiological model of personality by Cloninger and colleagues originally hypothesized that interindividual variability in the temperament dimension 'harm avoidance' (HA) is explained by differences in the activity of the brain serotonin system. We assessed brain serotonin transporter (5-HTT) density in vivo with positron emission tomography (PET) in healthy individuals with high or low HA scores using an 'oversampling' study design. Method Subjects consistently in either upper or lower quartiles for the HA trait were selected from a population-based cohort in Finland (n = 2075) with pre-existing Temperament and Character Inventory (TCI) scores. A total of 22 subjects free of psychiatric and somatic disorders were included in the matched high- and low-HA groups. The main outcome measure was regional 5-HTT binding potential (BPND) in high- and low-HA groups estimated with PET and [11C]N,N-dimethyl-2-(2-amino-4-methylphenylthio)benzylamine ([11C]MADAM). In secondary analyses, 5-HTT BPND was correlated with other TCI dimensions. RESULTS 5-HTT BPND did not differ between high- and low-HA groups in the midbrain or any other brain region. This result remained the same even after adjusting for other relevant TCI dimensions. Higher 5-HTT BPND in the raphe nucleus predicted higher scores in 'self-directedness'. CONCLUSIONS This study does not support an association between the temperament dimension HA and serotonin transporter density in healthy subjects. However, we found a link between high serotonin transporter density and high 'self-directedness' (ability to adapt and control one's behaviour to fit situations in accord with chosen goals and values). We suggest that biological factors are more important in explaining variability in character than previously thought.
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Affiliation(s)
- L Tuominen
- Department of Psychiatry, University of Turku, Turku, Finland
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Abstract
OBJECTIVE Recent research has linked hypertensive diseases of pregnancy with adverse neurodevelopmental outcomes in childhood and adulthood. This study aimed to establish whether such effects are observed in infancy. METHODS This was a prospective pregnancy cohort study of 2,785 pregnancies with complete data on hypertensive diseases of pregnancy. Mothers completed a validated Australian adaptation of the Toddler Temperament Scale when the children were 1 year of age (n = 2,384). Algorithms were used to classify children as difficult, slow to warm up, intermediate high, intermediate low, or easy, on the basis of their temperament scores. We then grouped difficult and intermediate-high infants together and compared them with easy, intermediate-low, and slow-to-warm-up infants. We used a multivariable logistic regression model and adjusted for known biomedical, sociodemographic, and psychological factors from the pre- and postnatal period that may influence child behavioral development. RESULTS After adjusting for confounders, mothers who were diagnosed with gestational hypertension (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.06-1.75) or preeclampsia (OR, 2.23; 95% CI, 1.18-4.23) were more likely to report that their infants were in the difficult or intermediate-high classifications in the first year of life compared with infants born to mothers without gestational hypertension or preeclampsia. CONCLUSION These data suggest that the link between maternal hypertensive diseases of pregnancy and child behavioral development begins in the first year of life.
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Mertol S, Alkın T. Temperament and character dimensions of patients with adult separation anxiety disorder. J Affect Disord 2012; 139:199-203. [PMID: 22440427 DOI: 10.1016/j.jad.2012.02.034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 02/23/2012] [Accepted: 02/23/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND There is growing evidence suggesting that separation anxiety can occur in adults. We aimed to determine temperament and character dimensions in patients with adult separation anxiety disorder (ASAD) compared to patients with panic disorder (PD) and healthy subjects. METHODS The study sample included 77 outpatients with ASAD, 44 outpatients with a PD with or without agoraphobia diagnosis, and 35 healthy subjects. ASAD diagnoses were confirmed with Structured Clinical Interview for Separation Anxiety Symptoms. Other measures included Adulthood Separation Anxiety Checklist, Separation Anxiety Symptom Inventory, and Temperament and Character Inventory (TCI). Group comparisons according to presence or absence of PD comorbidity in ASAD were also done. RESULTS Patients with ASAD scored higher in harm avoidance (HA) and scored lower in self-directedness (SD) compared to PD and control groups. Moreover, both PD patients and ASAD patients scored higher in RD, and self-transcendence dimensions than control subjects. All subscales of HA (anticipatory worry, fear of uncertainty, shyness, and fatigability) were significantly higher than controls. While HA scores were not different between ASAD and 'ASAD+PD' patients, HA levels of both groups were higher than PD alone and control groups. SD scores of patients with ASAD were lower than PD and control groups. LIMITATIONS Cross-sectional design and ASAD group have other anxiety disorders comorbidity which might affect the results. CONCLUSION Similar to PD and other anxiety disorders HA and RD was higher, and SD was lower in patients with ASAD compared to healthy subjects. Observed TCI profile is related to the ASAD itself since depression comorbidity was controlled.
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Predicting depression with psychopathology and temperament traits: the northern Finland 1966 birth cohort. DEPRESSION RESEARCH AND TREATMENT 2012; 2012:160905. [PMID: 22953056 PMCID: PMC3431048 DOI: 10.1155/2012/160905] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 07/01/2012] [Indexed: 01/06/2023]
Abstract
We studied the concurrent, predictive, and discriminate validity of psychopathology scales (e.g., schizotypal and depressive) and temperament traits for hospitalisations due to major depression. Temperament, perceptual aberration, physical and social anhedonia, Depression Subscale of Symptom Checklist (SCL-D), Hypomanic Personality Scale, Schizoidia Scale, and Bipolar II Scale were completed as part of the 31-year follow-up survey of the prospective Northern Finland 1966 Birth Cohort (n = 4941; 2214 males). Several of the scales were related to depression. Concurrent depression was especially related to higher perceptual aberration (effect size when compared to controls, d = 1.29), subsequent depression to high scores in SCL-D (d = 0.48). Physical anhedonia was lower in subjects with subsequent depression than those with other psychiatric disorders (d = -0.33, nonsignificant). Participants with concurrent (d = 0.70) and subsequent (d = 0.54) depression had high harm avoidance compared to controls, while differences compared to other psychiatric patients were small. Subjects with depression differed from healthy controls in most of the scales. Many of the scales were useful predictors for future hospital treatments, but were not diagnosis-specific. High harm avoidance is a potential indicator for subsequent depression.
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