Showing papers in "Journal of Nervous and Mental Disease in 1997"
TL;DR: The borderlines showed significantly lower levels of emotional awareness, less capacity to coordinate mixed valence feelings, lower accuracy at recognizing facial expressions of emotion, and more intense responses to negative emotions than the nonborderline controls, corroborate clinical observations of borderline patients' difficulties in regulating emotions.
Abstract: The aim of this study was to examine the ways in which adults with borderline personality disorder (BPD) experience and manage their feelings. Responses of 30 subjects who met the criteria for BPD on the Structured Clinical Interview for DSM-III-R were compared with 40 non-BPD controls on the following measures of emotion processing and affect regulation: 1) level of emotional awareness, 2) capacity to coordinate mixed valence feelings, 3) accuracy at identifying facial expressions of emotion, and 4) intensity of response to negative emotions. The results showed significant differences between the two groups on all measures. The borderlines showed significantly lower levels of emotional awareness, less capacity to coordinate mixed valence feelings, lower accuracy at recognizing facial expressions of emotion, and more intense responses to negative emotions than the nonborderline controls. The findings corroborate clinical observations of borderline patients' difficulties in regulating emotions. The implications of the results for the therapeutic management of BPD patients are discussed.
457 citations
TL;DR: Men and women did not significantly differ in terms of most variables examined, including rates of major depression, although women were more likely to be preoccupied with their hips and their weight, pick their skin and camouflage with makeup, and have comorbid bulimia nervosa.
Abstract: Gender differences in body dysmorphic disorder (BDD) have received little investigation. This study assessed gender differences in 188 subjects with BDD who were evaluated with instruments to assess demographic characteristics, clinical features of BDD, treatment history, and comorbid Axis I disorders. Ninety-three (49%) subjects were women, and 95 (51%) were men. Men and women did not significantly differ in terms of most variables examined, including rates of major depression, although women were more likely to be preoccupied with their hips and their weight, pick their skin and camouflage with makeup, and have comorbid bulimia nervosa. Men were more likely to be preoccupied with body build, genitals, and hair thinning, use a hat for camouflage, be unmarried, and have alcohol abuse or dependence. Although men were as likely as women to seek nonpsychiatric medical and surgical treatment, women were more likely to receive such care. Men, however, were as likely as women to have cosmetic surgery. Although the clinical features of BDD appear remarkably similar in women and men, there are some differences, some of which reflect those found in the general population, suggesting that cultural norms and values may influence the content of BDD symptoms.
407 citations
TL;DR: The initial reliability and validity data on the Adolescent Dissociative Experiences Scale (A-DES) showed good scale and subscale reliability, and, as hypothesized, increased scores were associated with reported trauma in a patient population.
Abstract: This study describes the initial reliability and validity data on the Adolescent Dissociative Experiences Scale (A-DES), a screening measure for pathological dissociation during adolescence. The A-DES showed good scale and subscale reliability, and, as hypothesized, increased scores were associated with reported trauma in a patient population. A-DES scores were able to distinguish dissociative disordered adolescents from a normal sample and from a patient sample with a variety of diagnoses.
320 citations
294 citations
TL;DR: In this paper, the authors examined internal and external risk factors for posttraumatic stress symptoms in 262 traumatized police officers and found that 7% of the entire sample had PTSD, as established by means of a structured interview.
Abstract: This study examines internal and external risk factors for posttraumatic stress symptoms in 262 traumatized police officers. Results show that 7% of the entire sample had PTSD, as established by means of a structured interview; 34% had posttraumatic stress symptoms or subthreshold PTSD. Trauma severity was the only predictor of posttraumatic stress symptoms identified at both 3 and 12 months posttrauma. At 3 months posttrauma, symptomatology was further predicted by introversion, difficulty in expressing feelings, emotional exhaustion at time of trauma, insufficient time allowed by employer for coming to terms with the trauma, dissatisfaction with organizational support, and insecure job future. At 12 months posttrauma, posttraumatic stress symptoms were further predicted by lack of hobbies, acute hyperarousal, subsequent traumatic events, job dissatisfaction, brooding over work, and lack of social interaction support in the private sphere. Implications of the findings regarding organizational risk factors are discussed in the light of possible occupational health interventions.
294 citations
TL;DR: Assessment of the association between attention deficit hyperactivity disorder (ADHD) and the age of onset of psychoactive substance use disorders (PSUD) in adults with ADHD confirmed and extended previous findings documenting important associations between PSUD and psychiatric comorbidity including persistent ADHD.
Abstract: We evaluated the association between attention deficit hyperactivity disorder (ADHD) and the age of onset of psychoactive substance use disorders (PSUD) in adults with ADHD. We hypothesized that ADHD and psychiatric comorbidity would be risk factors for early onset PSUD. We compared 120 referred adults having a clinical diagnosis of childhood-onset ADHD with 268 non-ADHD adults. All diagnoses were obtained using DSM-III-R based structured psychiatric interviews. We used group comparisons of age at onset and Cox proportional hazard models to examine the development of PSUD over time. ADHD was associated with earlier onset of PSUD independently of psychiatric comorbidity. Conduct and juvenile bipolar disorders conferred a significantly increased risk for early onset PSUD independently of ADHD. Psychiatric disorders commonly emerged before the onset of PSUD in both groups. Persistent ADHD with and without psychiatric comorbidity was associated with adolescent onset PSUD. In addition, comorbidity with conduct and juvenile bipolar disorders predicted very early onset PSUD in both ADHD and non-ADHD individuals. These findings confirm and extend previous findings documenting important associations between PSUD and psychiatric comorbidity including persistent ADHD.
292 citations
TL;DR: Employment is associated with better functioning in a range of different nonvocational domains, even after controlling for baseline levels of functioning.
Abstract: In this study we sought to understand the relationship between obtaining competitive employment and changes in nonvocational domains of functioning (symptoms, substance abuse, hospitalizations, self-esteem, quality of life) in persons with severe mental illness. A group of 143 unemployed patients participating in a study of vocational rehabilitation programs were assessed in nonvocational areas of functioning at baseline and 6, 12, and 18 months later. Statistical analyses examined the relationship between work status at the follow-up assessments and nonvocational functioning, controlling for baseline levels of nonvocational variables. Patients who were working at follow-up tended to have lower symptoms (particularly thought disorder and affect on the Brief Psychiatric Rating Scale), higher Global Assessment Scores, better self-esteem, and more satisfaction with their finances and vocational services than unemployed patients. Employment is associated with better functioning in a range of different nonvocational domains, even after controlling for baseline levels of functioning.
289 citations
TL;DR: Male patients with a history of chronic unipolar disorder are at risk for cognitive impairment in the nonsymptomatic phase of their disease and cognitive disturbance is the type seen with prefrontal dysfunction and may be assessed with standard neuropsychological assessments.
Abstract: Cognitive functioning in the nonsymptomatic phase and the long-term cognitive outcome of patients with mood disorders are both heuristic and important clinical issues in the study of mood disorders. Literature findings are inconsistent because of design confounds. We tried to address these issues while controlling for several confounds including age, education, gender differences in neurobehavioral functioning, and diagnosis. Nonsymptomatic patients with a history of chronic unipolar depression and bipolar affective disorder and healthy male individuals were administered neuropsychological tests to assess attention, visual-motor tracking, executive abilities, and immediate verbal memory. Subjects had comparable depression scores at the time of testing. Disease duration was 7.5 years (SD 5.1) for unipolar and 11 years (SD 7.3) for bipolar patients. Unipolar patients were more impaired than healthy normal comparison subjects on measures of visual-motor sequencing (Trail Making Test A, p < .05), executive function (Trail Making Test B, Stroop Test Color/Word Trial, p < .05), and immediate memory and attention (CERAD 1st trial, WAIS Digit Symbol subtest, p < .05). Differences between bipolar patients and normal comparison subjects did not reach significance in any of the selected measures. Male patients with a history of chronic unipolar disorder are at risk for cognitive impairment in the nonsymptomatic phase of their disease. Cognitive disturbance is the type seen with prefrontal dysfunction and may be assessed with standard neuropsychological assessments.
261 citations
TL;DR: Adult ADHD patients had high comorbidity with current depressive disorder, antisocial personality disorder, and alcohol and drug abuse/dependence and high correlations were found between patients' and independent observers' reports of ADHD symptom severity.
Abstract: Compared to attention deficit hyperactivity disorder (ADHD) in children, relatively little is known about the clinical characteristics of adults with persistent ADHD. We elected to use established tests with age-corrected norms to compare the battery of psychological and neuropsychological tests conducted on outpatients admitted to our Adult ADHD clinic. ADHD patients scored significantly higher than norms on the TPQ novelty seeking and harm avoidance scales and MMPI-2 scales F, 2, 4, 7, and 8. Further, these patients were impaired on the California verbal learning test, the attentional capacity test, and the omissions and variability subtests of the test of variables of attention. Adult ADHD had high comorbidity with current depressive disorder, antisocial personality disorder, and alcohol and drug abuse/dependence. High correlations were found between patients' and independent observers' reports of ADHD symptom severity. Implications for further research are discussed.
253 citations
TL;DR: This descriptive study used a between-methods triangulation design to analyze the multiple dimensions of quality of life in persons with chronic fatigue syndrome (CFS).
Abstract: This descriptive study used a between-methods triangulation design to analyze the multiple dimensions of quality of life in persons with chronic fatigue syndrome (CFS). This method, which refers to the combination of both quantitative and qualitative methods in the same study, allowed the authors to
231 citations
TL;DR: Dysfunction of orbitofrontal and basotemporal cortices of the right hemisphere may result in disinhibited behaviors in patients with closed head injuries, brain tumors, stroke lesions, and focal epilepsy.
Abstract: Disinhibition syndromes, ranging from mildly inappropriate social behavior to full blown mania, may result from lesions to specific brain areas. Several studies in patients with closed head injuries, brain tumors, stroke lesions, and focal epilepsy have demonstrated a significant association between disinhibition syndromes and dysfunction of orbitofrontal and basotemporal cortices of the right hemisphere. Based on the phylogenetic origin of these cortical areas and their main connections with dorsal regions related to visuospatial functions, somatosensation, and spatial memory, the orbitofrontal and basotemporal cortices may selectively inhibit or release motor, instinctive, affective, and intellectual behaviors elaborated in the dorsal cortex. Thus, dysfunction of these heteromodal ventral brain areas may result in disinhibited behaviors.
TL;DR: Logistic regression analyses indicated that both child abuse and adult assaults were uniquely associated with psychiatric difficulties, even after controlling for relevant background variables.
Abstract: Studies on the impacts of violence often overlook the moderating role of social or demographic variables and the confounding effects of different victimization experiences on the same individual. In the present study, 93 adult women presenting to an urban psychiatric emergency room were interviewed regarding their lifetime victimization history, and their charts were examined for relevant demographic and psychiatric variables. Self-reported childhood sexual and physical abuse were common in this sample (53% and 42%, respectively). Adult physical assaults outside of a relationship were described by 29% of patients, 37% reported adult sexual assaults or rapes, and 42% stated that they had experienced one or more physical assaults within an adult relationship. Childhood and adult victimization experiences were intercorrelated and were associated with certain sociodemographic variables. Logistic regression analyses indicated that both child abuse and adult assaults were uniquely associated with psychiatric difficulties, even after controlling for relevant background variables. Childhood sexual abuse was the most powerful predictor of later psychiatric symptoms and disorders.
TL;DR: The integrated treatment group had fewer institutional days and more days in stable housing, made more progress toward recovery from substance abuse, and showed greater improvement of alcohol use disorders than the standard treatment group.
Abstract: This study examined the effects of integrating mental health, substance abuse, and housing interventions for homeless persons with co-occurring severe mental illness and substance use disorder. With the use of a quasi-experimental design, integrated treatment was compared with standard treatment for 217 homeless, dually diagnosed adults over an 18-month period. The integrated treatment group had fewer institutional days and more days in stable housing, made more progress toward recovery from substance abuse, and showed greater improvement of alcohol use disorders than the standard treatment group. Abuse of drugs other than alcohol (primarily cocaine) improved similarly for both groups. Secondary outcomes, such as psychiatric symptoms, functional status, and quality of life, also improved for both groups, with minimal group differences favoring integrated treatment.
TL;DR: Findings support DSM-IV descriptions of GAD as involving pervasive worry that includes worry about minor things, and GAD was characterized by equally high relative frequencies for miscellaneous and work/school worries, whereas control groups had higher relative frequency for work/ school concerns and lower relative frequenciesfor miscellaneous worries.
Abstract: The hypothesis of a distinctive content pattern of worry in generalized anxiety disorder (GAD) was investigated with the use of content categorization of GAD versus nonanxious control worries from both clinical and analogue samples. The GAD groups reported significantly more worry topics than the control groups. Some similarity in content patterns emerged across groups, with the most frequent content category for all groups involving family/interpersonal issues. However, a significant difference in the pattern of relative frequencies across groups was found: GAD was characterized by equally high relative frequencies for miscellaneous and work/school worries, whereas control groups had higher relative frequencies for work/school concerns and lower relative frequencies for miscellaneous worries. The miscellaneous worries of GAD individuals were particularly characterized by worry about minor/routine issues. These findings support DSM-IV descriptions of GAD as involving pervasive worry that includes worry about minor things.
TL;DR: The combination of antidepressants with exposure in vivo is the most potent short-term treatment of PA, and all seven treatments were superior to the control condition for panic attacks.
Abstract: To compare short-term efficacy of benzodiazepines, antidepressants, psychological panic management, exposure in vivo, and combination treatments in panic disorder with or without agoraphobia (PA), a meta-analysis was conducted. Included were 106 studies, pertaining to 222 treatment conditions, 5,011 patients at pretest and 4,016 at post-test. Pre/post effect sizes Cohen's d were calculated within the treatment conditions for four clinical variables: panic, agoraphobia, depression, and general anxiety. Seven large treatment conditions were used in the main analyses: high-potency benzodiazepines, antidepressants, psychological panic management, exposure in vivo, pill-placebo combined with exposure, antidepressants combined with exposure, and psychological panic management combined with exposure in vivo. First, these treatments were compared with a control condition, consisting of pill-placebo, attention placebo, and waiting list. Next, a comparison was made between the treatments. Antidepressants, psychological panic management, high-potency benzodiazepines, and antidepressants combined with exposure in vivo were superior to the control condition for panic attacks. Exposure in vivo alone was not effective for panic attacks. With regard to agoraphobic avoidance, all seven treatments were superior to the control condition. When comparing the various treatment conditions, no differences concerning panic attacks were found. For agoraphobic avoidance, the combination of antidepressants with exposure in vivo was superior to the other conditions. The combination of antidepressants with exposure in vivo is the most potent short-term treatment of PA.
TL;DR: Family studies of ADHD, family studies of depression, and one population-based family study strongly support the assertion of a familial link between ADHD and depression.
Abstract: Comorbidity between ADHD and major depression has been reported from both epidemiologic and clinical studies of both children and adults Our goal was to assess the validity of the association by reviewing family studies of the two disorders We examined this issue from a genetic epidemiologic perspective by searching the literature for family studies of ADHD children that had assessed depression in relatives and family studies of depressed children that had assessed ADHD in relatives Family studies of ADHD, family studies of depression, and one population-based family study strongly support the assertion of a familial link between ADHD and depression ADHD families with antisocial disorders show the greatest risk for depression However, in the absence of antisocial disorders, ADHD also imparts a familial risk for depression ADHD and major depression probably share familial risk factors, and the difference between depressed and nondepressed ADHD patients can be attributed to environmental factors Depression in an ADHD child should not be routinely dismissed as demoralization secondary to ADHD, and depression in mothers of ADHD children should not always be attributed to the stress of living with an ADHD child The converse statements are equally valid: ADHD in depressed children may not be secondary to depression, and ADHD in the children of depressed mothers may not be a transactional response to the mother's depression
TL;DR: Using classification analysis, temporal pattern and location of the pain were found to be the best predictors of physical diagnoses, although none of the taxa in the three classification systems tested were related to psychosocial outcomes.
Abstract: This study investigated the clinical attributes of dyspareunia and the variables used to classify it. A systematic clinical description of the pain symptomatology was obtained through the administration of a structured interview and standardized pain measures to 112 women suffering from dyspareunia, ranging in age from 19 to 65. Subjects also underwent three different gynecological examinations and completed standardized measures of psychopathology, marital adjustment, and sexual attitudes, the results of which were used to test the ability of three different classification systems, including the DSM-IV, to predict physical and psychosocial outcomes. Using classification analysis, temporal pattern and location of the pain were found to be the best predictors of physical diagnoses, although none of the taxa in the three classification systems tested were related to psychosocial outcomes. Sexual impairment of women suffering from dyspareunia notwithstanding, the results support the consideration of dyspareunia as primarily a pain syndrome, rather than a sexual dysfunction.
TL;DR: The data suggest that personality profiles can be looked at in schizophrenia, that these profiles do appear stable over time, and that negative symptoms have a strong influence on profile stability and appear to be "trait-like."
Abstract: This study was performed in an effort to begin characterization of personality traits in schizophrenia. Specific concerns included personality profiles relative to normal adults, personality profile stability over time, and trait-state issues. The authors administered the NEO Personality Inventory as well as symptom ratings at two time points to 21 patients. Patients were all stabilized outpatients attending an adult continuing day treatment program and diagnosed with either schizophrenia or schizoaffective disorder. Personality profiles were determined for all patients. Compared with a normal adult sample, this sample's scores on three out of five of the personality domains assessed were not distinguishable from normal adults. Test-retest correlations were highly significant over an average 28.2-week time interval. In general, the presence of positive symptoms did not appear related to NEO-PI stability, while negative symptoms did show a relationship to the stability of personality profiles. These data suggest that personality profiles can be looked at in schizophrenia, that these profiles do appear stable over time, and that negative symptoms have a strong influence on profile stability and appear to be "trait-like."
TL;DR: Comparisons of physiological and subjective responses to an autogenic relaxation exercise and three different laboratory stressors find some support for the hypothesized mechanisms of alexithymia, and suggest specific links between alexithsymia and clinical disorders.
Abstract: Alexithymia has been linked to various disorders, including compulsive behaviors, anxiety disorders, and physical conditions with or without symptoms. It has been hypothesized that these disorders result from the alexithymic inability to differentiate and elaborate affect, which gives rise to physiological arousal and a negative subjective state, which are not regulated by psychological strategies. We tested these hypothesized mechanisms by comparing 42 alexithymic subjects with 42 sex- and race-matched non-alexithymic subjects on physiological and subjective responses to an autogenic relaxation exercise and three different laboratory stressors. Alexithymic subjects had tonically greater electrodermal activity and reported more arousal and displeasure in general than nonalexithymic subjects. Groups did not differ in the degree to which they relaxed, but alexithymic subjects reported less enjoyment of, less involvement in, and poorer imagery during relaxation. All three stressors evoked reactivity, and alexithymic women had less heart rate change when viewing disgusting scenes than did nonalexithymic women; in general, however, groups did not differ in reactivity or recovery to the stressors. We find some support for the hypothesized mechanisms of alexithymia, and we suggest specific links between alexithymia and clinical disorders.
TL;DR: It is hypothesized that gender would differentially influence the localization of the preoccupations as well as the extent and type of comorbidity with other psychiatric disorders, and BDD does appear to be an autonomous syndrome, and gender tends to influence the nature and extent of this comorebidity.
Abstract: Body Dysmorphic Disorder (BDD), which consists of pathological preoccupations with defects in different body parts, has been systematically studied only in the last decade. We hypothesized that gender would differentially influence the localization of the preoccupations as well as the extent and type of comorbidity with other psychiatric disorders. With the use of a specially constructed semistructured interview, we evaluated 58 consecutive outpatients with DSM-III-R BDD (women = 41.4%, men = 58.6%). Women had significantly more preoccupations with breast and legs, checking in the mirror and camouflaging, as well as lifetime comorbidity with panic, generalized anxiety, and bulimia. Men had significantly higher preoccupations with genitals, height, excessive body hair, as well as higher lifetime comorbidity with bipolar disorder. Although BDD is almost never found without comorbidity, it does appear to be an autonomous syndrome, and gender tends to influence the nature and extent of this comorbidity.
TL;DR: Results offer tentative confirmation of functional somatic syndromes as discrete entities and suggest that relaxing the diagnostic criteria for somatization may identify individuals with distress limited to a single functional system.
Abstract: Latent variable models of functional somatic symptoms were estimated for a sample of 686 family medicine patients. Symptom items from the NIMH Diagnostic Interview Schedule were selected to approximate diagnoses of fibromyalgia syndrome (FMS), chronic fatigue syndrome (CFS), and irritable bowel syndrome (IBS). Confirmatory factor analysis demonstrated that hypothesized latent variables of somatic depression, somatic anxiety, FM-like, CF-like, and IB-like syndromes fit the observed covariations better than models hypothesizing fewer latent variables. Results offer tentative confirmation of functional somatic syndromes as discrete entities and suggest that relaxing the diagnostic criteria for somatization may identify individuals with distress limited to a single functional system.
TL;DR: Examination of longitudinal changes in satisfaction indicated the QOLI is responsive to changes in global life, leisure activities, living situation, and social relations from hospital admission to discharge (an average of 2 weeks), which supports the use of the Q OLI as an outcome measure to assess quality of life in acutely ill hospitalized psychiatric patients.
Abstract: This study examined the reliability, validity, and responsiveness of Lehman's Quality of Life Interview (QOLI) as an outcome measure on 981 acutely ill psychiatric inpatients assessed longitudinally at admission and discharge. Patients were stratified into five diagnostic (DX) (depressed bipolar, depressed unipolar, schizophrenia, mania, and other diagnoses) and two substance use disorder (SA) strata (with and without concurrent substance abuse/dependence) based on DSM-III-R criteria. There was good replication of the factor structure, excellent internal consistency, overall and within DX and SA groups. Intercorrelations showed that the functional and satisfaction indices measure unique aspects of the quality of life. The construct consistency of the QOLI was dependent upon psychiatric diagnosis and life domain. Intercorrelations of functional and satisfaction indices for patients with depression were greater than for manic patients. We demonstrated strong consistency of construct validity for family and social relation domains, but not safety or leisure activities. Construct validity was shown to hold longitudinally. Analyses of DX and SA group differences on satisfaction and functional indices of the 8 life domains supported discriminative validity: Depressed patients reported the most dissatisfaction, followed by schizophrenic patients, and manic patients reported the greatest satisfaction in most life domains. Patients with concurrent substance abuse generally reported less satisfaction and lower quality of life than patients without a dual diagnosis. Examination of longitudinal changes in satisfaction indicated the QOLI is responsive to changes in global life, leisure activities, living situation, and social relations from hospital admission to discharge (an average of 2 weeks). This study supports the use of the QOLI as an outcome measure to assess quality of life in acutely ill hospitalized psychiatric patients.
TL;DR: Investigation of whether a psychotic illness was associated with posttraumatic stress disorder (PTSD) symptomatology in 45 subjects recovering from hospitalization for a psychotic episode met the criteria for a postpsychotic PTSD, with implications for recognition and management of secondary morbidity related to psychosis.
Abstract: This study investigated whether a psychotic illness was associated with posttraumatic stress disorder (PTSD) symptomatology in 45 subjects recovering from hospitalization for a psychotic episode. Previous studies have suggested that the experience of psychosis and hospitalization is distressing and that PTSD may be a useful paradigm for the psychological response. Subjects were given questionnaires to evaluate PTSD symptoms, anxiety symptoms, and distress and intrusive memories associated with aspects of treatment and psychosis. Treatment, especially experiences involving a loss of control such as detention, and psychotic symptoms, particularly persecutory delusions, passivity phenomena, and visual hallucinations, were perceived as highly distressing. Twenty-two subjects (52%) met the criteria for a postpsychotic PTSD, with implications for recognition and management of secondary morbidity related to psychosis.
TL;DR: Psychiatric patients had lower spiritual well-being scores and were less likely to have talked with their clergy, and they may need assistance to find resources to address their religious needs.
Abstract: A recent survey of psychiatric research indicates religion has been given little attention, and when it has been considered, the measures have been simplistic. The present study was designed to describe the religious needs and resources of psychiatric inpatients. With the use of a multidimensional conception of religion and two established instruments, 51 adult psychiatric inpatients were surveyed about their religious needs and resources. For comparison, 50 general medical/surgical patients, matched for age and gender, were also surveyed. Eighty-eight percent of the psychiatric patients reported three or more current religious needs. Although there were no differences in religious needs between the two patient groups, there were significant differences in religious resources. Psychiatric patients had lower spiritual well-being scores and were less likely to have talked with their clergy. Religion is important for the psychiatric patients, but they may need assistance to find resources to address their religious needs.
TL;DR: The relationship between social network disturbances following earthquake evacuation and self-reported psychological distress (reduced version of the SCL-90-R) 3 to 4 years later was studied among 817 Italian male factory workers and is consistent with the hypothesis that disaster related distress is a function of resulting social network disruption.
Abstract: The relationship between social network disturbances following earthquake evacuation and self-reported psychological distress (reduced version of the SCL-90-R) 3 to 4 years later was studied among 817 Italian male factory workers. Increased distress was reported by permanently relocated men, while those who were evacuated, but returned to their original homes, reported distress levels comparable to their nonevacuated co-workers. Additionally, among evacuated men, only those whose relocation placed them at an increased distance from family and/or friends reported distress levels higher than the nonevacuated. Change in visiting frequency with family and/or friends following evacuation was not related to distress. Although these data are correlational and cross-sectional, they are consistent with the hypothesis that disaster related distress is, in part, a function of resulting social network disruption.
TL;DR: The correlational data showed that the DSM PDs were most strongly associated with the FFM domains of neuroticism, extraversion, and agreeableness, and factor analysis revealed four underlying factors that provided insights into qualities shared by subgroups of the DSM-IV PDs.
Abstract: This study explored the associations among the domains of the five-factor model (FFM) of personality (neuroticism, extraversion, openness, agreeableness, and conscientiousness) and the DSM-IV personality disorders (PDs). Clinician ratings were obtained for both the DSM-IV PDs and the FFM on a sample of 100 PD patients. The correlational data showed that the DSM PDs were most strongly associated with the FFM domains of neuroticism, extraversion, and agreeableness. Factor analysis revealed four underlying factors that provided insights into qualities shared by subgroups of the DSM-IV PDs. The domain of neuroticism was associated with the borderline, avoidant, and dependent PDs (factor 1). The paranoid, avoidant, schizoid, and schizotypal PDs were negatively associated with the domain of agreeableness (factor 2). The domain of extraversion was positively associated with the narcissistic and histrionic PDs and negatively with schizoid PD (factor 3). The FFM conscientiousness and openness domains loaded onto a single factor and were positively associated with the obsessive-compulsive PD and negatively associated with the antisocial and borderline PDs. Exploring the relationships between these two personality systems will improve our conceptualization and understanding of the DSM PDs.
TL;DR: Investigation of whether anxiety or depressive disorders are related to the use of specific defenses and which defenses are associated with self-report measures for anxiety and depression found no evidence for a gender specific association.
Abstract: The aim of the present study was threefold: (a) to investigate whether anxiety or depressive disorders are related to the use of specific defenses; (b) to evaluate which defenses are associated with self-report measures for anxiety and depression; and (c) to assess whether the association between defenses and anxiety or depression is gender specific. Subjects were 483 consecutive psychiatric outpatients with the following DSM-III-R diagnoses: (a) V-code or no psychiatric diagnosis (N = 71) (controls); (b) one or two anxiety diagnoses (N = 116), among which 47 patients with a single diagnosis of panic disorder; (c) one or two depressive disorder diagnoses (N = 93), among which 35 patients with a single diagnosis of dysthymia and 51 with a single diagnosis of major depression; and (d) 203 otherwise. Defense use was measured with the Defense Style Questionnaire-36 and level of anxiety and depression with the Symptom Checklist-90. Compared to controls, anxiety and depressive disorder patients scored higher for the immature defense style. Moreover, anxiety disorder patients obtained significantly higher scores for the neurotic defense style than both depressive disorder patients and controls. Panic patients made more use of the defense mechanisms of somatization, devaluation, and idealization, and dysthymic patients of somatization, devaluation, and isolation. Both anxiety and depression scores were positively related to the immature and neurotic, and negatively to the mature defense style. Anxiety was predominantly related to somatization and depression to projection. No evidence for a gender specific association between defense and anxiety or depression was found. It is concluded that the observed differences in defense between groups may be a consequence of the nature of the psychiatric disorder irrespective of gender. Prospective studies of persons at risk are needed to evaluate whether specific defenses are predictive of anxiety or depressive disorders and/or symptoms.
TL;DR: The current literature on CBS and related phenomena is reviewed, specific criteria to define this syndrome is offered, and future work in this area is suggested.
Abstract: The Charles Bonnet syndrome (CBS) derives from complex visual hallucinations. Neurologists, ophthalmologists, and psychiatrists have studied this entity for many years. Despite interest in CBS recently in contemporary American medical literature, investigators have not agreed upon a universal definition of this entity. This article reviews the current literature on CBS and related phenomena, offers specific criteria to define this syndrome, and suggests future work in this area.