Diagnostic Differential Between Pedophilic-OCD and Pedophilic Disorder: An Illustration with Two Vignettes

Despite the prevalence of atypical sexual thoughts in OCD presentations, research suggests that treatment providers often misclassify OCD with pedophilic obsessions (P-OCD) as pedophilic disorder. Such misdiagnoses can have adverse effects including inappropriate treatment, worsening of symptoms, and potential legal complications. Given these iatrogenic effects, clinicians must be competent in differentiating between these two conditions. To clarify the difficult differential between P-OCD and pedophilic disorder, the current paper provides readers with two vignettes that illustrate the differential process. These vignettes highlight important distinctions in symptom presentations and common pitfalls when assessing for P-OCD and pedophilic disorder. The first vignette describes a 32-year-old married woman who experienced pedophilic-themed intrusive thoughts, leading her to avoid children and certain interactions with her daughter. The second vignette describes a 42-year-old married man who experienced ego-dystonic attraction toward minors, particularly 8-10-year-old girls. Following these vignettes, treatment implications and forensic implications are discussed. Finally, recommendations for future clinical and empirical work are made.

Obsessive Thought, Compulsive Behavior, and Their Associations With Suicide Ideation and Attempts and Major Depressive Disorder: A Nationwide Community Sample of Korean Adults

ABSTRACT

In this study, we defined obsessive thoughts (OT) as bothersome, unpleasant thoughts about oneself that keep entering the mind against one's will, and compulsive behavior (CB) as behavior that a person repeats against his or her wishes. The study included 12,532 adults selected randomly through a one-person-per-household method. Each subject selected underwent a face-to-face interview using the Korean version of the Composite International Diagnostic Interview with a questionnaire that examines lifetime suicide attempts (LSAs). Among the participants, 341 (2.74%) had OT and 639 (5.14%) had CB. The highest LSA rate was in subjects with both OT and CB, followed by those with either OT or CB; subjects with neither OT nor CB had the lowest LSA rate. In a multivariate logistic regression analysis of OT and CB, OT, ordering, and rituals of repeating words were significantly associated with LSAs. In subjects with OT and CB, those with MDD had a significantly higher risk of LSAs compared with those without, and MDD with both OT and CB showed odds of approximately 27-fold (adjusted odds ratio, 27.24; 13.29-55.82; p < 0.0001) compared with those without MDD, OT, or CB. OT and CB were associated with increased risk of LSAs, and comorbid MDD further increased LSAs.

Psychological impact of COVID-19 and contributing factors of students' preventive behavior based on HBM in Gondar, Ethiopia

BACKGROUND

The Ethiopian Federal government has locked down schools as one measure to contain Covid-19 pandemic. Psychological effect of COVID-19 on students is increased due to the reopening of schools. The psychological effect of the pandemic is increasing along with physical aspect of health. Therefore, this study aimed to assess the psychological impact of Covid-19 and its contributing factors of students' behavior in Ethiopia.

METHODS

A cross sectional design was conducted from November to December 2020. Data were collected using pre tested self- administered questionnaire from secondary school students in Gondar city North West Ethiopia. Stratified simple random sampling technique was used to select 403 secondary school students. Data were entered and cleaned with Epidata version 4.62 and exported for analysis STATA version 14. Multivariable logistic regression and multiple linear regression were used to show the association of dependent and independent variables. Independent variables in relation to dependent variable measured using odd ratios and B coefficient with 95% confidence interval for Covid-19 anxiety and preventive behavior of Covid-19 respectively were used.

RESULTS

A total of 370 students were participated giving response rate of 92%. The prevalence of Covid-19 anxiety and obsession among secondary school students were 38.1% and 40.27% respectively. Being 11thgrade 54% (AOR = 0.46; 95%CI:0.22, 0.95) and increased knowledge16% (AOR = 0.84;95%CI: 0.77, 0.89) score associated with decreased COVID-19 anxiety while Covid-19 obsession, 14.51 times (AOR = 14.51;95%CI: 8.05, 26.17), and being female 1.6 times (AOR = 1.6; 95%CI: 1.01, 2.51) increased Covid-19 Anxiety. Furthermore, increased self-efficacy 0.5 times (B = 0.5; 95%CI: 0.28, 0.62), and increased cues to action 0.4 times (B = 0.4; 95% CI: 0.19, 0.69) increased preventive behavior of Covid-19 while perceived barrier 0.1 times (B = -0.1; 95%CI:-0.22, 0.01) decrease preventive behavior of Covid-19.

CONCLUSION

Almost two individuals of five participants developed COVID-19 anxiety and COVID-19 obsession. Being grade 11th and knowledge were negatively associated with anxiety while being female and being obsessed with COVID-19 were positively associated with anxiety. No variable was associated with obsession of Covid-19. Intervention is needed to reduce anxiety among females. Furthermore, perceived barrier, self-efficacy and cues to action were significant factors of preventive behaviour of Covid-19. Therefore, to increase preventive behaviour of Covid-19, information, education and communication and behavioural change communication should be targeted on reducing barriers and increasing motivations and confidences.

The Prevalence of Orthorexia Nervosa in Polish and Lebanese Adults and Its Relationship with Sociodemographic Variables and BMI Ranges: A Cross-Cultural Perspective

The prevalence of orthorexia nervosa (ON) appears to be increasing, and more research into its cross-cultural aspects is required to provide culturally appropriate psychological treatment. Until now, there has been relatively little research published about ON across cultures. Therefore, the objectives of the present study were to determine: (1) the prevalence of ON in Polish and Lebanese adults and (2) the association between ON and sociodemographic variables and Body Mass Index (BMI) in two culturally different samples. One thousand two hundred and sixty-two adults participated in the present study (NPoland = 743 adults; NLebanon = 519 adults). The Düsseldorf Orthorexia Scale and the Eating Habits Questionnaire were used in the present study. Information about age, sex, anthropometry, and marital status was obtained from all participants as well. The Polish sample had an ON prevalence rate of 2.6%, while the Lebanese sample had an ON prevalence rate of 8.4%. No significant correlation was found between ON and age in both samples. A statistically significant difference was found between marital status and country on ON, with the highest mean score seen among Lebanese singles. In Lebanon, having a low of BMI ≤ 25 kg/m2 compared to a high BMI was significantly associated with lower ON tendencies, while this association was not significant among Polish participants. This study was the second to focus on the prevalence of ON in Western and non-Western countries and its association with sociodemographic characteristics and BMI ranges. Knowledge about ON and its correlates in diverse populations may inform the design of culturally tailored behavior change interventions and the development of culturally appropriate tools in various groups to improve their dietary patterns.

Disentangling orthorexia nervosa from healthy eating and other eating disorder symptoms: Relationships with clinical impairment, comorbidity, and self-reported food choices

BACKGROUND

Orthorexia nervosa (ON) is characterized by obsessions about eating healthily and rigid adherence to a perceived healthy diet. This study uses the Eating Habits Questionnaire to investigate the relationship of ON symptoms with self-reported food intake, eating-related impairment, obsessive compulsive disorder symptoms (OCD), gender, and BMI while controlling for other eating disordered symptoms. The aim of this study is to provide further evidence for the construct of ON as distinct from other forms of disordered eating.

METHODS

The sample consisted of 449 adults recruited on Amazon's Mechanical Turk. Self-reported symptoms of currently recognized eating disorders (anorexia and bulimia nervosa, AN/BN, avoidant/restrictive food intake disorder, ARFID) were statistically controlled in correlational analyses and MANCOVA exploring the relationship of ON domains to comorbidity, eating behavior, gender, and weight.

RESULTS

Confirmatory factor analysis supported a three-factor solution for the EHQ, with factors representing normative healthy eating behaviors ("behaviors"), positive feelings associated with healthy eating ("feelings"), and interference/problems from rigid healthy eating ("problems"). Overall ON symptoms were more strongly related to AN/BN than to ARFID. Of the subscales, only Problems was related to other eating disorder symptomatology. Controlling for other eating disorder symptoms, overall ON symptomatology was not related to clinical impairment from eating or OCD, although it was related to higher self-reported intake of fruits/vegetables and lower intake of discretionary foods. When other eating disordered symptoms and ON domains were statistically controlled, Problems was related to clinical eating impairment, OCD symptoms, and higher intake of both fruits/vegetables and discretionary foods.

CONCLUSIONS

The Problems scale of the EHQ appears to capture disordered eating symptomatology that is distinct from other eating disorders and from normative healthy eating behaviors, consistent with descriptions of ON.

Orthorexia nervosa in a sample of Portuguese fitness participants

PURPOSE

Orthorexia Nervosa (ON) is described as an obsessive behaviour motivated by great concern for following a healthy diet. Although it was first described in 1997, ON remains inconspicuous and poorly characterized in the literature. The aims of this study were to evaluate the prevalence of ON in a sample of ambulatory individuals and to investigate their common characteristics, attempting to better characterize this entity.

METHODS

A non-random sample of 193 adult gym members answered a questionnaire based on a Portuguese version of ORTO-15, supplemented with additional questions. Possible associations between the different variables and pathological scores on ORTO-15 were analysed using logistic regression models.

RESULTS

ON behaviour was documented in 51.8% of the sample, mean age 30.96 years (± 1.03 years), and this condition tended to be correlated with younger ages. Physical appearance and frequent exercising were also associated with ON, while no correlation between orthorexic tendencies and both gender and educational field was found. Furthermore, consumption of special food, dissatisfaction with physical appearance and frequent exercising could predict the presence of ON in the sample.

CONCLUSIONS

Despite the use of a convenience sample, results place us in a different perspective, considering the idea that orthorexic individuals are exclusively concerned about pursuing a pure diet. The presence of ON was associated with other non-dietary behaviours allied to a healthy lifestyle and aesthetic concerns.

LEVEL OF EVIDENCE

Level V: Descriptive study.

Frequency of obsessive compulsive symptoms in depression: A hospital-based cross-sectional study

OBJECTIVE

To determine the frequency of obsessive compulsive symptoms in patients suffering from depression.

METHODS

This cross-sectional study was conducted at the Allama Iqbal Memorial Teaching, Sialkot, Pakistan, from February 2014 to March 2017, and comprised patients suffering from depression. Every patient was examined by a consultant psychiatrist or a senior medical officer in psychiatry, and a psychologist to establish clinical diagnosis of depression according to the tenth revision of the International Statistical Classification of Diseases and Related Health Problems. Adult patients suffering from depression were included. Patients with severe physical illnesses, other psychiatric illnesses, current, past or family history of obsessive compulsive disorder and drug abuse were excluded. Beck Depression Inventory and Yale Brown Obsessive Compulsive Scale were also administered. Data was analysed using SPSS 21.

RESULTS

Of the 5,127 patients, 2,318(45.21%) were males and 2,809(54.79%) females. The mean age of the male and female patients was 35.17±12.39 years (range: 18-73 years) and 33.67±13.27 years (range: 18-70 years), respectively. Besides, 1,991(38.83%) patients had moderate depression, 1,647(32.13%) had mild depression and 1,489(29.04%) had severe depression. Moreover, 1,673(32.63%) patients had obsessive compulsive symptoms, including 497(29.70%) patients with mild depression, 599(35.80%) with moderate depression and 577(34.49%) with severe depression.

CONCLUSIONS

Around one-third participants had obsessive compulsive symptoms.

A Comparative Study of Obsessionality in Medical Students, Law Students, and Controls

Understanding obsessive-compulsive behavior in medical students and law students is necessary for administrators and educators to properly work with students struggling with obsessionality. We aim to compare the differences in obsessive symptoms between medical students, law students and a control population. A total of 100 third-year medical students, 102 third-year law students and 103 control subjects drawn from the general population completed the Leyton Obsessional Inventory (LOI). Subjects were examined on all three sections (symptoms/traits, resistance and interference) of the LOI. Obsessional symptom scores for medical students (14.29 ± 7.33) and law students (13.65 ± 6.61) were significantly greater than for the control group (11.58 ± 7.45). Medical and law students were both more likely to report checking, order, routine and attention to detail as obsessive symptoms. Medical students were more likely than law students to possess the obsessive symptoms of cleanliness and conscientiousness, while law students were more likely than medical students to possess obsessive symptoms related to difficulty in making up their mind and doubting themselves. While medical students and law students are more obsessional than the control population, each group is more likely to report different obsessive symptoms.

[Stalking of social healthcare workers: preliminary results of a study conducted by the region of Apulia, Italy]

AIM

This study has the aim to represent the degree of information/training about the identification of possible stalking acts and their frequency, within the context of public and private National Healthcare and Social Assistance.

MATERIALS AND METHODS

Socio-demographic data both of victims and possible stalkers, circumstances of events and the emotional responses of victims are gathered up by a multiple choice questionnaire , made by 20 questions, given to a sample of 101 subjects, which are practitioners within Healthcare and Social Assistance area (doctors, psychologists, nurses, social-health operators) both of public and private health facilities.

RESULTS

Considering our sample, subjects which point out harassments linked to stalking are 30/101 (29.7%). Female sex is mainly represented F=22/30 (73, 3%) compared to male sex M=8/30 (26, 7%). 30, 14% of female health operators (nr 22/73) and 28, 57% of male health operators (nr 8/28) affirm that they are victims of harassments.

DISCUSSION

The results indicate a lack of attention towards the stalking phenomenon, a limited trust of victims to the institutions, but also the persistence of a backward culture, within social and health services, about stalking, preventatives strategies of it and counter-actions of the harassment. Only a small part of them, 16.1%, reports what is happened or turn to anti-violence centres.

CONCLUSION

The study highlights that information about stalking and its psychological consequences on victims/operators are insufficient in social and health area. It is necessary the star up of awareness campaigns, which gives information to practitioners of public and private Healthcare and Social Assistance area about characteristics of stalking and the way by which avoid its risks and prevent it.

Women Who Are Stalked

The authors use logistic regression with the National Violence Against Women Survey sample ( N = 8,000) to explore patterns in fear reported by women who were stalked. One fourth of our sample felt no fear, with Black women significantly less likely to report fear (compared to White women). Women who were frequently stalked, stalked by an intimate or family member or acquaintance, or stalked by physical or communicative means reported feeling fearful more than did others. Requiring a woman to feel fearful before accepting her experience as an instance of stalking risks, the authors conclude, a miscarriage of justice, an undercount of the crime, and an abandonment of women (and others) who need validation from the state and protection from stalkers.

Women’s Experience of Violence During Stalking by Former Romantic Partners

This study investigated female experiences of physical violence during stalking by a former romantic partner. It aimed to identify factors that were predictive of such stalking violence. Two hundred and twenty female undergraduates who defined themselves as victims of stalking following the dissolution of a romantic relationship completed a short questionnaire. From their responses, 11 predictor variables were considered. These were self-reported relationship experiences of physical and sexual violence, intentional damage to participant’s property, partner jealousy, isolation, monitoring, criticism and insults by the former partner, former partner’s drug and alcohol abuse, and specific threats of violence while being stalked. The dependent variable in the study was whether stalking violence occurred; 35.9% (79/220) of participants experienced stalking violence. Logistic regression analysis revealed that there were statistically significant independent associations between threats, partner jealousy, and former partner drug abuse and stalking violence.

Domains of distress among people with sexual orientation obsessions

Although sexual obsessions in obsessive-compulsive disorder (OCD) are not uncommon, obsessions about sexual orientation have not been well studied. These obsessions focus on issues such as the fear of being or becoming gay, fear of being perceived by others as gay, and unwanted mental images involving homosexual acts. Sexual orientation obsessions in OCD are particularly distressing due to the ego-dystonic nature of the obsessions and, often, stigma surrounding a same-sex orientation. The purpose of this study was to better understand distress in people suffering from sexual orientation obsessions in OCD. Data were collected online (n = 1,176) and subjects were 74.6% male, 72.0% heterosexual, and 26.4% with an OCD diagnosis from a professional. The survey consisted of 70 novel questions that were assessed using a principal components analysis and the items separated into six components. These components were then correlated to distress among those with a prior OCD diagnosis and sexual orientation obsessions. Results indicated that sexual orientation obsessions in OCD were related to severe distress, including suicidal ideation. Implications of these findings and future directions for research are discussed.

Is obsessive-compulsive symptomatology a risk factor for Alzheimer-type dementia?

In the present study, we hypothesized that lifetime Obsessive-Compulsive (OC) symptomatology would be risk factors for the development of Alzheimer׳s disease (AD). For this aim, first we compared 39 patients with AD and 30 age and gender matched control subjects. We have found that lifetime and current OC symptoms (OCs) and comorbid diagnosis of Obsessive-Compulsive Personality Disorder in AD patients were significantly more prevalent than in control group. AD patients had more likely to have lifetime and current hoarding, and checking obsessions compared to controls. The rate of lifetime and current hoarding, and checking compulsions also appeared to be higher in AD patients in comparison to control subjects. Hoarding and checking obsessions, and compulsions seemed to proceed through the dementia in contrast to other OCs. The mean number of lifetime compulsions seemed to predict the diagnosis of AD. When we compared AD patients with and without OCs, we have found that OC symptomatology prior to AD did not cause an earlier onset of dementia and more severe cognitive impairment. Further longitudinal clinical, genetic and neuroimaging investigations are required to determine if lifetime presence of OCs would predispose to the development of later AD.

Do children with gender dysphoria have intense/obsessional interests?

This study examined whether children clinically referred for gender dysphoria (GD) show increased symptoms of autism spectrum disorder (ASD). Circumscribed preoccupations or intense interests were considered as overlapping symptoms expressed in GD and ASD. In gender-referred children (n = 534; 82.2% male) and their siblings (n = 419; 57.5% male), we examined Items 9 and 66 on the Child Behavior Checklist, which measure obsessions and compulsions, respectively. Non-GD clinic-referred (n = 1,201; 48.5% male) and nonreferred (n = 1,201; 48.5% male) children were also examined. Gender-referred children were elevated compared to all other groups for Item 9, and compared to siblings and nonreferred children for Item 66. A gender-related theme was significantly more common for gender-referred boys than male siblings on Item 9 only. A gender-related theme was not significantly more common for gender-referred girls compared to their female siblings on either item. The findings for Item 9 support the idea that children with GD show an elevation in obsessional interests. For gender-referred boys in particular, gender-related themes constituted more than half of the examples provided by their mothers. Intense/obsessional interests in children with GD may be one of the factors underlying the purported link between GD and ASD.

A comparative study of obsessive beliefs in obsessive-compulsive disorder, anxiety disorder patients and a normal group

Cognitive models of obsessive-compulsive disorder (OCD) posit that specific kinds of dysfunctional beliefs underlie the development of this disorder. The aim of present study was to determine whether these beliefs are endorsed more strongly by OCD patients than by those with other anxiety disorders and by community samples. A battery of questionnaires, including the OBQ-44, MOCI, BDI-II, BAI, STAI, used to assess obsessive-compulsive symptoms, depression and anxiety in 39 OCD patients (OC), 46 anxious patients (AC) and 41 community controls (CC). Compared to CCs and ACs, OC patients more strongly endorsed beliefs related to importance and control of thoughts. Both OC and AC patients scored higher than CC participants did on belief domains about responsibility/threat estimation and perfectionism/certainty. Therefore, the domain that seems to be specific to OCD is a set of beliefs that revolves around the contention that it is possible and necessary to control one's thoughts. Results regarding group differences on particular items of the OBQ-44 indicated that 21 items discriminated between the OC and CC groups and 7 items discriminated between the OC and AC groups, suggesting that these items are more specific to the OC group. Additional research warranted because it is plausible that these cognitive factors relate differently to OCD phenomena across different cultures.

Primary and secondary exercise dependence in a community-based sample of road race runners

The purpose of our study was to examine exercise dependence (EXD) in a large community-based sample of runners. The secondary purpose of this study was to examine differences in EXD symptoms between primary and secondary EXD. Our sample included 2660 runners recruited from a local road race (M age = 38.78 years, SD = 10.80; 66.39% women; 91.62% Caucasian) who completed all study measures online within 3 weeks of the race. In this study, EXD prevalence was lower than most previously reported rates (gamma = .248, p < .001) and individuals in the at-risk for EXD category participated in longer distance races, F(8,1) = 14.13, p = .01, partial eta squared = .05. Group differences were found for gender, F(1,1921) 8.08, p = .01, partial eta squared = .004, and primary or secondary group status, F(1,1921) 159.53, p = .01, partial eta squared = .077. Implications of primary and secondary EXD differences and future research are discussed.

Stressful life events and material deprivation in hoarding disorder

Traumatic life events and early material deprivation have been identified as potential environmental risk factors for the development of pathological hoarding behavior, but the evidence so far is preliminary and confounded by the presence of comorbid obsessive-compulsive disorder (OCD). This study retrospectively examined the occurrence of traumatic/stressful life events and material deprivation in four well-characterized groups: hoarding disorder without comorbid OCD (HD; n=24), hoarding disorder with comorbid OCD (HD+OCD; n=20), OCD without hoarding symptoms (OCD; n=17), and non-clinical controls (Control; n=20). Participants completed clinician and self-administered measures of hoarding, OCD, depression, psychological adjustment, and traumatic experience. Semi-structured interviews were undertaken to assess the temporal relation between traumatic/stressful life events and the onset and worsening of hoarding symptoms, and to determine the level of material deprivation. Although rates of post-traumatic stress disorder were comparable across all three clinical groups, hoarders (regardless of the presence of comorbid OCD) reported greater exposure to a range of traumatic and stressful life events compared to the two non-hoarding groups. Results remained unchanged after controlling for age, gender, education level, depression, and obsessive-compulsive symptoms. The total number of traumatic life events correlated significantly with the severity of hoarding but not of obsessive-compulsive symptoms. About half (52%) of hoarding individuals linked the onset of hoarding difficulties to stressful life circumstances, although this was significantly less common among those reporting early childhood onset of hoarding behavior. There was no link between levels of material deprivation and hoarding. Results support a link between trauma, life stress and hoarding, which may help to inform the conceptualization and treatment of hoarding disorder, but await confirmation in a representative epidemiological sample and using a longitudinal design.

Gender differences in acknowledgment of stalking victimization: results from the NCVS stalking supplement

Research suggests that a significant portion of victims of interpersonal violence do not acknowledge or label their experience as a criminal victimization. Studies exploring unacknowledged victimizations have found that individuals are more likely to acknowledge victimization when the experience meets certain, often stereotypical criteria. This study addressed this issue by integrating literature on victim acknowledgment and stalking victimization to identify correlates of victimization acknowledgment among stalking victims. Data were drawn from the 2006 stalking supplement to the National Crime Victimization Survey (NCVS), and the sample included both female and male victims of stalking. Findings revealed support for a "classic stalking script," which included a reliance on stereotypical types of stalking behavior (i.e., being spied on) that were shown to increase acknowledgment for victims of stalking. Results also described gender based correlates of victimization acknowledgment.

Student pursuers: an investigation of pursuit and stalking in the student-faculty relationship

Data from faculty and students provide information on the prevalence of unwanted pursuit and stalking in the student-faculty relationship. Among faculty, 67.8% reported unwanted pursuit. For the most serious case, 6%-11% met criteria for stalking. Among students, 4.1% reported engaging in unwanted pursuit of faculty. Both faculty and students perceived anger (especially for male students) to be the motive for student unwanted pursuit/stalking, with some endorsement of romantic interest and concern about the role of mental illness. Sex differences suggest female faculty members are more often a target of unwanted pursuit or stalking and more likely to experience fear.

[Early signs and symptoms before the psychotic onset. A study on the Duration of Untreated Illness (DUI) in a sample of patients with diagnosis of "non-affective psychotic disorders"]

AIMS

The aims of the study are to evaluate, in the Italian context, the presence and clinical features of early prodromal symptoms before the psychotic onset and, most of all, the duration of the period between the first onset of any psychiatric symptom and the psychotic onset (Duration of Untreated Illness).

MATERIALS AND METHODS

The study was carried out on a sample of 296 inpatients with a diagnosis of "non-affective psychosis" enrolled in "Villa dei Fiori" inpatients Clinic in Rome. The retrospective analysis was developed using clinical records and clinical interview with patients and their parents. The evaluation of the psychotic onset and of DUI was assessed with the PANSS (Positive and Negative Symptoms Scale).

RESULTS

The mean DUI is 4.7 ± 4.4 years. We found a connection between DUI and early symptoms of psycosis: depressive symptoms (4.9; DS=5.0) were most frequently observed, followed by anxiety symptoms (5.1; DS=4.8), eating disorders (5.7; DS=3.0); obsessive symptoms (4.5; DS=3.6); social withdrawal (5.9; DS=4.9); psychotic like symptoms (2.6; DS=1.3). DUI resulted lower in psychotic like symptoms than in the depressive ones.

CONCLUSION

In Italy DUI turn out to be much longer than in other Country where do exists specialized services for early intervention. For this reason seem to be necessary to explore the opportunity to develop also in Italy specialized services for adolescents and young adults at risk and at their psychotic onset.

Are stalkers recidivists? Repeated offending by convicted stalkers

Stalking is an obsessive behavior. Legal definitions generally characterize stalking as repetitive conduct. It may therefore be expected that recidivism by stalkers is high. We investigated court statistics of stalking cases to establish which proportion relapses in stalking behavior after a conviction and what other types of new crimes they commit. Case files of stalking cases have been investigated to find out whether and which neutralization techniques are used by stalkers to justify harassing behaviors. Stalkers who do recidivate do so quickly after a conviction. They appear to make use of various neutralization techniques. There is a small group of highly obsessive stalkers that seems not to be stopped by any of the measures, sanctions, or interventions that are imposed.

Clinico-demographic profiles in obsessive compulsive disorders

INTRODUCTION

Obsessive compulsive disorder (OCD) is one of the most prevalent and debilitating mental illnesses. The present study was conducted to find out the clinico-demographic profiles of Nepalese OCD patients in the local set up.

METHODS

We used the criteria of OCD as per the ICD-10: Classification of Mental and Behavioral Disorders' as a diagnostic and 'Yale Brown Obsessive Compulsive Scale' as a rating tool. Patients diagnosed as OCD were included and related information collected with their consent.

RESULTS

Of 60 cases, 39 (65%) were male. The most common age groups were 20-29 (43%) and 30-39 (28%). Most of the subjects were relatively better educated. About half were married. More than half presented after more than five years of onset of illness. Seventy percent had some precipitating stressors. The most common obsessions were doubt (62%) and ruminations (57%); and compulsions checking (35%) and washing (28%). Somatic (28%) and mood symptoms (22%) were other common presenting complaints. About 7% had high suicidal intents. Nearly two thirds presented when they had YBOC Score of severe ranges, mean YBOC score being in the severe range (24).

CONCLUSIONS

Most of the OCD patients present late only when severely affected. This indicates need for public awareness program in our set up.

Identifying predictors of negative psychological reactions to stalking victimization

Victims of stalking often experience a number of negative psychological problems including such things as fear, symptoms of depression, and anger. However, research on factors that lead to these outcomes is limited. The goal of this study was to first identify distinct subgroups of stalking victims based on measures of psychological problems resulting from being stalked. Once identified, the next step was to examine the influence of demographic and stalking-related variables on the probability of subgroup membership. The results revealed that respondents who were female, had a prior relationship with the stalker, experienced a greater variety of stalking behaviors, were divorced/separated, and reported receiving government assistance were more likely to be classified into subgroups characterized by a high probability of experiencing multiple negative outcomes.

Prevalence of stalking victimization in journalists: an E-mail survey of German journalists

Certain professionals, such as health care personnel, have a higher risk of stalking victimization because of their professional activities. This study analyzed the lifetime prevalence of stalking victimization for journalists because they belong to a professional group that often works in public, demonstrates personal attitudes and opinions, and thus may easily become objects for positive or negative transferences. Four hundred and ninety-three journalists answered a standardized Internet questionnaire on stalking victimization. Twelve percent of respondents reported common stalking due to nonprofessional reasons, and an additional 2.2% reported apparently job-related stalking. In contrast to common stalking, job-related stalking victims were mostly male and took the perpetration less seriously, although they had the same risk of suffering violence and aggressive attacks. Since stalking can cause severe psychological distress in victims and some cases are at high risk for aggressive violence, better information for this professional group is necessary. Primary and secondary preventive strategies should be considered.

Schizotypal personality traits in Gilles de la Tourette syndrome

OBJECTIVES

Gilles de la Tourette syndrome (GTS) is a chronic tic disorder associated with comorbid psychopathology, including obsessionality, affective instability and attention-deficit hyperactivity disorder. Evidence linking GTS with schizophrenia-like symptoms is limited and equivocal, despite a common putative substrate involving dopaminergic dysfunction within frontostriatal circuits. The aim of this study was to quantify the prevalence of schizotypal traits in GTS and to detail the relationship between schizotypy and comorbid psychopathology.

MATERIALS AND METHODS

A total of 102 subjects with GTS were evaluated using the Schizotypal Personality Questionnaire and standardized neurological and psychiatric rating scales. The predictive interrelation between schizotypy, tic-related symptoms and psychiatric comorbidities was investigated using correlation and multiple regression analyses.

RESULTS

In our clinical population, 15% of the subjects were diagnosed with the schizotypal personality disorder according to the DSM-IV criteria. The strongest predictors of schizotypy were obsessionality and anxiety ratings. The presence of multiple psychiatric comorbidities correlated positively with schizotypy scores.

CONCLUSIONS

Schizotypal traits are relatively common in patients with GTS, and reflect the presence of comorbid psychopathology, related to the anxiety spectrum. In particular, our preliminary results are consistent with a shared neurochemical substrate for the mechanisms underpinning tic expression, obsessionality and specific schizotypal traits.

Multiaxiale Klassifikation von Stalkingfällen

Stalking is a widespread phenomenon describing a pattern of intrusive and threatening behaviour that leads to the victim's perception of being harassed and of him or her being rendered fearful. Physical assault and even homicide may occur in the context of stalking. Anglo-Saxon studies have revealed a lifetime prevalence of being a victim of stalking ranging from 4-7% in men and 12-17% in women. Recently, these rates have been confirmed by the first community based study carried out in Germany. As a stalker can have a number of victims during his or her lifetime, the prevalence of stalkers may be less than this, although at present data for this are lacking. Although the phenomenology of stalking appears to be rather homogenous, fairly distinct stalker typologies and perpetrator-victim relationships have to be considered. Requests for psychiatric and forensic assessment of stalkers are increasing. According to the German penal code, psychiatrists must provide expert opinion on criminal responsibility and the placement of stalkers. So far, all typologies of stalkers refer to the Anglo-Saxon cultural background and do not consider the special needs of German forensic psychiatry. In particular, the psychopathological dimension is widely neglected in common typologies. The present paper proposes a multiaxial typology of stalking that considers the psychopathological dimension, the relationship between stalker and victim and motivational aspects. Consequences for the forensic psychiatric assessment according to section 20, 21 StGB are outlined. It should be pointed out that stalking is not a new diagnostic category, but only involves, at a descriptive level, deviation from a normal behavioural pattern. The central components of the forensic psychiatric assessment remain the known diagnostic categories, the effects of which on behaviour can be analysed.

[The effects of stalking on psychiatrists, psychotherapists and psychologists. Prevalence of stalking and its emotional impact]

Stalking in the psychiatric context describes a pathological behaviour which is characterized by repeated persecution, harassment, or menacing of or assault on a person. Because of the association between stalking and mental disorders, psychiatrists, psychologists and psychotherapists belong to particularly exposed professions. If they fall victim to stalking during their career, disruptive impacts up to posttraumatic stress disorder (PTSD) can be the consequence. A total of 117 psychiatrists, psychologists or psychotherapists in Graz participated in an anonymous interview. To register possible experiences with stalking defined behaviour, a modified version of the questionnaire of Kamleiter was used. The prevalence and severity of posttraumatic stress symptoms were determined using the Impact of Event Scale of Horowitz. The study showed an incidence of stalking of 38.5%. The rate of female stalkers (60%) was extraordinary high. Most victims (68.9%) experienced non-violent threats. Most of the offenders (41.9%) were diagnosed as suffering from schizophrenia, schizotype and delusional disorders (F2) followed by disorders of adult personality and behaviour (F6) (30.2%). Some 44.4% of the victims developed symptoms of PTSD, which were usually only slight. The analyses suggest that stalking, in the psychiatric field of activity, is a common and serious phenomenon, and that strategies for the prevention and protection of potentially affected professions have to be developed.

Nature & prevalence of stalking among New Zealand mental health clinicians

Stalking involves recurrent and persistent unwanted communication or contact that generates fear for safety in the victims. This pilot study evaluated the nature and prevalence of stalking among New Zealand nurses and physicians working in mental health services. An anonymous questionnaire asking respondents to describe their experiences with 12 stalking behaviors was distributed to 895 clinicians. Results indicated that regardless of discipline, women were more likely than men to have experienced one or more stalking behaviors, including receiving unwanted telephone calls, letters, and approaches; receiving personal threats: and being followed, spied on, or subject to surveillance. Women also reported higher levels of fearfulness as a consequence of stalking behaviors. Nearly half of the stalkers were clients; the remaining were former partners, colleagues, or acquaintances. In client-related cases, the majority of respondents told their colleagues and supervisors first, and the majority found them to be the most helpful resource. The results of this pilot study indicate a need for further research focused on the stalking of mental health clinicians in New Zealand and for development of workplace policies for adequate response to the stalking of mental health clinicians.

Intrusive thoughts, obsessions, and appraisals in obsessive–compulsive disorder: A critical review

This article reviews empirical findings on two key premises of the appraisal model of obsessive-compulsive disorder (OCD): (a) non-clinical populations experience intrusive thoughts (ITs) that are similar in form and in content to obsessions; and (b) ITs develop into obsessions because they are appraised according to dysfunctional beliefs. There is support for the universality of ITs. However, the samples used are not representative of the general population. IT measures do not relate systematically or exclusively to OCD symptom measures, and are not specific enough to exclude other types of intrusive thoughts such as negative automatic thoughts or worries, nor are they representative of all types of obsessions. When general distress is controlled, there is so far no evidence that participants with OCD endorse obsessive belief domains more strongly than anxious participants, and inconclusive evidence that OCD and non-clinical samples differ on the belief domains. Some OCD symptom subtypes are associated with belief domains. Currently, there is no coherent model to offer strong predictions about the specificity of the empirically derived belief domains in OCD symptom subtypes. Cognitive therapy based on the appraisal model is an effective treatment for OCD, although it does not add to the treatment efficacy of behaviour therapy. It is unclear how appraisals turn ITs into obsessions. Implications for future research are discussed.

What can we learn from the first community-based epidemiological study on stalking in Germany?

There is a lack of community-based studies on prevalence rates of stalking and the impact of stalking on victims in continental European countries. The authors published the first community-based epidemiological study on stalking in Germany. The purpose of this paper is to discuss possible implications of these epidemiological data for the mental health system, forensic psychiatry and legal regulations in Germany. For these reasons some data of our epidemiological study are outlined and reanalyzed. To examine lifetime and point prevalence rates of stalking, behavioural and psychological consequences for victims and the impact of stalking on current psychological well-being in a German community sample, a postal survey was conducted with 2000 inhabitants randomly selected from Mannheim (response rate 34.2%, n=679). The survey included a stalking questionnaire and the WHO-5 well-being scale. Almost 12% of the respondents reported having been stalked. This study identified a high lifetime prevalence of stalking in the community. Effects on victims' psychological health were significant and there was a high rate of physical (31%) and sexual (19%) violence in the context of stalking. Our data suggest that the phenomenon deserves more attention in future forensic psychiatric research and practice. Implications for forensic psychiatric assessment and treatment of stalkers as well as for management of stalking victims are discussed.

Parent-adolescent relationships and the development of weight concerns from early to late adolescence

OBJECTIVE

This work describes the developmental course of adolescents' weight concerns and examines links with changes in parent-adolescent relationships for girls and boys.

METHOD

Adolescents and parents in 191 families participated in 3 annual home interviews; adolescents rated their weight concerns and their intimacy and conflict with parents. Parental knowledge was measured based on the match between adolescents' and parents' reports of youth's experiences each day during 7 evening telephone calls.

RESULTS

Girls' weight concerns increased from age 11 to 16 and then declined, whereas boys' concerns declined beginning at age 11. Increases in girls' weight concerns were linked to increases in conflict with mothers and fathers and decreases in maternal intimacy and knowledge. At a trend level, declines in boys' weight concerns were associated with declines in father conflict.

CONCLUSION

Mothers and fathers may have unique influences on adolescent weight concerns. Intervention programming should target parent-adolescent relationships.

Executive functioning in anorexia nervosa: exploration of the role of obsessionality, depression and starvation

Cognitive deficits related to executive functioning have been previously identified in anorexia nervosa (AN). Currently, there is limited knowledge about the degree to which other variables related to AN or executive function may influence the observed relationships. The present study examined three groups of participants, women with AN (n=22), and two control groups: women who were high in obessionality (n=20) and women who were low in obsessionality (n=21). Women reporting disordered eating over the previous 4 weeks were screened out of the control groups. Executive function was measured using the Wisconsin card sorting test (WCST) and the uses of common objects test (UCOT). In addition, depression, obsessionality and body mass index were measured. Initial analyses showed no significant differences between the groups on executive function, but moderate effect sizes were obtained for performance on UCOT total perseverations and WCST total trials. When controlling for either depression or obsessionality, the group differences on the UCOT total perseverations became significant and in the case of depression attained a large effect size. Both the AN and high obsessional groups showed significantly more perseverations than the low obsessional group. Depression appeared to suppress variance that was irrelevant to the prediction of perseverance thus enhancing the importance of group membership. It is recommended that variables strongly associated with AN be investigated in future research as this may clarify the relationship between AN and executive function.

Sexual obsessions and clinical correlates in adults with obsessive-compulsive disorder

Because little is known about sexual obsessions in individuals with obsessive-compulsive disorder (OCD), we examined rates and clinical correlates of sexual obsessions in 293 consecutive subjects with primary lifetime Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, OCD (54.6% females; mean age, 40.5 +/- 12.9 years). Symptom severity was examined using the Yale-Brown Obsessive Compulsive Scale. Comorbidity, treatment response, insight, depression symptoms, quality of life, and social functioning were also assessed. All variables were compared in subjects who have OCD with and without sexual obsessions. Of the 293 subjects with primary OCD, 73 (24.9%) reported a history of sexual obsessions, and 39 (13.3%) of the subjects with OCD reported current sexual obsessions. Women were as likely as men to report sexual obsessions. As compared to those without these symptoms, subjects with current sexual obsessions were significantly more likely to report current aggressive (P < .001) and religious (P = .001) obsessions. Subjects with sexual obsessions also reported an earlier age of onset of OCD than subjects without these symptoms. Severity of OCD, comorbidity, treatment response, insight, depressive symptoms, quality of life, and social functioning did not differ between those with and without sexual obsessions. These preliminary results suggest that sexual obsessions are fairly common among individuals with OCD and may be associated with important clinical characteristics.

The epidemiology and characteristics of stalking

PURPOSE OF REVIEW

This article summarizes major results in the field of epidemiology and characteristics of stalking, as published in literature between 2003 and October 2005.

RECENT FINDINGS

Although stalking had been only recently conceptualized, it soon became evident that it represents a significant social and medical problem. Community-based studies on the prevalence of stalking are scarce and predominantly from English-speaking countries. All epidemiological studies, however, revealed that stalking is a widespread phenomenon with lifetime prevalence rates of stalking victimization ranging 12-16% among women and 4-7% among men. With regard to the impact of stalking, studies suggest that stalking can cause serious economic, social, medical and psychiatric consequences. Growing evidence suggests that serious violence and even homicide may occur in the context of stalking, and research on risk assessment has yielded an improved understanding of risk factors. Research on therapy of stalkers and stalking victims is still at its beginning; however, there are some preliminary reports with encouraging results.

SUMMARY

Although there are research activities in the main fields, many basic questions still remain to be adequately addressed. Increased social and political awareness and expanded research funding are obligatory prerequisites to realize sound and well designed studies.

The temperament and character inventory in women with migraine

The purpose of this work was to investigate: (1) the differences in temperament and character between 49 women with migraine and 49 controls using the Temperament and Character Inventory (TCI), and (2) the extent to which these differences were related to migraine or to the presence of comorbid depression. The migraine patients scored significantly higher than the controls in two temperament dimensions—Harm Avoidance (HA) and Persistence (P)—and significantly lower in one character dimension—Self-Directedness (SDir) (Student’s t). After multiple logistic regression, the TCI P and HA dimensions were significantly associated with the presence of migraine. The HA dimension was also related to the presence of depression. Our results show that in migraine the higher HA score could be partly associated to comorbid depression while the high P dimension seems to be solely related to the presence of migraine.

Lifetime prevalence and impact of stalking in a European population: epidemiological data from a middle-sized German city

BACKGROUND

There is a lack of community-based studies on prevalence rates of stalking and the impact of stalking on victims in European countries.

AIMS

To examine lifetime and point prevalence rates of stalking, behavioural and psychological consequences for victims, and the impact of stalking on current psychological well-being in a German community sample.

METHOD

A postal survey was conducted with a sample randomly selected from the population of a middle-sized German city; 679 people (400 women, 279 men) responded. The survey included a stalking questionnaire and the WHO-5 well-being scale.

RESULTS

Almost 12% of the respondents (n=78, 68 women, 10 men) reported having been stalked. A multiple regression analysis revealed a significant effect of victimisation on psychological well-being.

CONCLUSIONS

This study identified a high lifetime prevalence of stalking in the community. Effects on victims' psychological health are significant, suggesting that the phenomenon deserves more attention in future community mental health research.

Obsessive compulsive behavior, hyperactivity, and attention deficit disorder in Sydenham chorea

The authors investigated obsessive-compulsive behavior, obsessive-compulsive disorder (OCD), and attention deficit and hyperactivity disorder (ADHD) in 50 healthy subjects, 50 patients with rheumatic fever without chorea, and 56 patients with Sydenham chorea. Obsessive-compulsive behavior, OCD, and ADHD were more frequent in the Sydenham chorea group (19%, 23.2%, 30.4%) than in the healthy subjects (11%, 4%, 8%) and in the rheumatic fever without chorea group (14%, 6%, 8%). ADHD was more common in persistent Sydenham chorea.

Psychiatrische Relevanz von Stalking

AIMS

To provide an overview on the psychiatric significance of stalking and the implications for the health care system.

RESULTS

Stalking is a widespread phenomenon and can result in significant health care problems.

CONCLUSION

In the future physicians will have to deal with this problem in a professional manner.

Hyperactivity in anorexia nervosa: a case study using experience sampling methodology

Hyperactivity is frequently observed in eating disorders, and several biopsychological mechanisms have been proposed to explain its pathogenetic role. In view of the lack of a reliable method to study hyperactive behavior, we did an experiment with experience sampling methodology (ESM). During 1 week, an anorexia nervosa (AN) patient was asked at nine random times a day to report her momentary tendency to be physically active, her emotions and several other variables including calorie expenditure, drive for thinness, attractiveness, obsessions, compulsions, and attitudes towards hyperactivity. Results indicate that the patient's tendency to be hyperactive was (a) positively related to her weight preoccupation and her negative emotions, and (b) negatively related to her positive emotions and the absence of depression. In this patient, obsessions and compulsions were not related to hyperactivity. The usefulness of ESM for studying the role of hyperactivity in AN is discussed.

Female stalkers and their victims

Demographic, clinical, and forensic data were gathered in an archival study of 82 female stalkers from the United States, Canada, and Australia. Female stalkers were predominantly single, heterosexual, educated individuals in their mid 30s who had pursued their victims for more than a year. Major mental disorder and personality disorder were suggested, especially borderline personality disorder. They usually threatened violence, and if they did threaten, were more likely to be violent. Frequency of interpersonal violence was 25 percent, but there was limited use of weapons, and injuries were minor. Stalking victims were most likely to be slightly older male acquaintances; but if the victim was a prior sexual intimate of the female stalker, her risk of being violent toward him exceeded 50 percent. Unlike male stalkers who often pursue their victims to restore intimacy, these female stalkers often pursued their victims to establish intimacy. Common emotions and motivations included anger, obsessional thoughts, rage at abandonment, loneliness, dependency, jealousy, and perceived betrayal. Results are interpreted from a clinical and risk management perspective.

A cognitive profile of individuals who tend to worship celebrities

Celebrity worship is a form of parasocial interaction in which individuals become obsessed with 1 or more celebrities, similar to an erotomanic type of delusional disorder. Drawing on the cognitive factors implicated in erotomania, the authors hypothesized that celebrity worshippers might be expected to exhibit verbal, visuospatial, and cognitive deficits related to flexibility and associative learning. This general hypothesis was tested in a sample of 102 participants who completed the Celebrity Attitude Scale (L. E. McCutcheon, R. Lange, & J. Houran, 2002), the Entertainment-Social, Intense-Personal, and Borderline Pathological subscales, and 6 cognitive measures that included creativity (verbal), crystallized intelligence, critical thinking, spatial ability, and need for cognition. The results were consistent with predictions and suggest that cognitive deficits only help facilitate an individual's susceptibility to engage in celebrity worship. The results are discussed in terms of the multivariate absorption-addiction model of celebrity worship.

Recidivism in stalking and obsessional harassment

Despite the rapidly growth of mental health attention focused on the phenomenon of stalking, no empirical research to date has attempted to assess the frequency of repeat offending or attempted to identify predictors of recidivism. A total of 148 stalking and harassment offenders who were court-ordered to undergo a mental health evaluation were followed for a period of 2.5-13 years in order to assess the frequency of repeat offenses and the variables that differentiated high versus low risk offenders. Recidivism data were obtained from a variety of sources, including criminal justice records, mental health records, and reports from probation officers and victims. A number of potential "predictor" variables were selected on the basis of the existing recidivism literature in other criminal justice populations. Frequency analysis were used to identify variables that significantly differentiated offenders who did and did not reoffened while survival analysis was used to analyze the impact of these covariates on time to reoffense. A total of 49% of the offenders reoffended during the follow-up period, 80% of whom reoffended during the first year. The strongest predictors of recidivism included the presence of a personality disorder, and in particular, a "Cluster B" personality disorder (i.e., antisocial, borderline, and/or narcissistic). In addition, those offenders with both a personality disorder and a history of substance abuse were significantly more likely to reoffened compared to either of these risk factors alone. Surprisingly, the presence of a delusional disorder (e.g., erotomania) was associated with a lower risk of reoffender. The findings are discussed in terms of the legal system and treatment implications.

Alcohol craving predicts drinking during treatment: an analysis of three assessment instruments

OBJECTIVE

The purpose of this investigation was to examine the utility of thee craving instruments to predict drinking during treatment. The three assessments used were the Penn Alcohol Craving Scale (PACS), the Alcohol Urge Questionnaire (AUQ) and Items 1-6 of the Obsessive subscale (OBS) of the Obsessive Compulsive Drinking Scale (OCDS).

METHOD

The three instruments were administered during the course of a 9-month, double-blind, placebo-controlled trial of 100 mg/day of naltrexone, and a manual-based psychosocial intervention using the BRENDA manual conducted at the University of Pennsylvania's Treatment Research Center. Participants (133 men and 50 women at the initiation of the study) used these instruments to self-report craving on a weekly or biweekly basis. The weekly number of drinks was reported using the Timeline Followback interview. The data were analyzed with generalized estimating equations using craving scores at 1 week as the independent variable and number of drinks in the subsequent treatment week as the dependent variable.

RESULTS

Each of the three scales predicted drinking during the subsequent treatment week. The PACS was the strongest predictor followed closely by the OBS and then the AUQ. Most important, craving as measured by the three scales was a stronger predictor of subsequent drinking than was drinking during the prior treatment week.

CONCLUSIONS

Craving assessment provides a useful means of predicting drinking during treatment. Such information would be helpful in designing clinical trials and for many treatment modalities.

Mood disorder history and personality assessment in premenstrual dysphoric disorder

BACKGROUND

Menstrually related dysphoria is known to be associated with other affective disorders, notably major depressive disorder and puerperal depression. The relationship between premenstrual dysphoric disorder (PMDD) and maladaptive personality disorders and traits, however, is less established, at least in part because of the methodological and nosologic difficulties in the diagnosis of both PMDD and personality disorders. This study seeks to address this problem to elucidate the relationship between PMDD, other affective disturbances commonly experienced by women, and maladaptive personality.

METHOD

Axis I and II disorders were examined using standardized instruments and stringent diagnostic criteria (DSM-IV and the International Personality Disorders Examination) in 34 women with DSM-IV PMDD and 22 healthy women without severe premenstrual mood changes.

RESULTS

Seventy-seven percent of the PMDD group had suffered from a past Axis I disorder in comparison with 17% of the control group. Two thirds of the parous women with PMDD had suffered from major depressive disorder in the puerperium. Personality disorder diagnoses were not highly represented in either group of women. The women with PMDD had significantly more obsessional personality traits (p < .001 ) but not absolute personality disorder diagnoses.

CONCLUSION

Obsessional symptoms are known to cluster with the affective disorders and may reflect underlying temperamental and biological vulnerability. This study provides further evidence of the link between serotonergic dysregulation, personality vulnerability, and mood changes related to the female reproductive cycle.

Obsessional personality features in employed Japanese adults with a lifetime history of depression: assessment by the Munich Personality Test (MPT)

BACKGROUND

Although a number of studies have reported on the association between obsessional personality features as measured by the Munich Personality Test (MPT) "Rigidity" scale and depression, there has been no examination of these relationships in a non-clinical sample.

METHODS

The dimensional scores on the MPT were compared between subjects with and without lifetime depression, using a sample of employed Japanese adults. The odds ratio for suffering from lifetime depression was estimated by multiple logistic regression analysis. To diagnose a lifetime history of depression, the Inventory to Diagnose Depression, Lifetime version (IDDL) was used.

RESULTS

The subjects with lifetime depression scored significantly higher on the "Rigidity" scale than the subjects without lifetime depression. In our logistic regression analysis, three risk factors were identified as each independently increasing a person's risk for suffering from lifetime depression: higher levels of "Rigidity", being of the female gender, and suffering from current depressive symptoms.

CONCLUSION

The MPT "Rigidity" scale is a sensitive measure of personality features that occur with depression.