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Xu Q, Lui S, Ji Y, Cheng J, Zhang LJ, Zhang B, Zhu W, Geng Z, Cui G, Zhang Q, Liao W, Yu Y, Zhang H, Gao B, Xu X, Han T, Yao Z, Qin W, Liu F, Liang M, Fu J, Xu J, Zhang P, Li W, Shi D, Wang C, Gao JH, Yan Z, Chen F, Li J, Zhang J, Wang D, Shen W, Miao Y, Xian J, Wang M, Ye Z, Zhang X, Zuo XN, Xu K, Qiu S, Yu C. Distinct effects of early-stage and late-stage socioeconomic factors on brain and behavioral traits. Nat Neurosci 2025; 28:676-687. [PMID: 39994408 DOI: 10.1038/s41593-025-01882-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 12/31/2024] [Indexed: 02/26/2025]
Abstract
Socioeconomic status (SES) is a time-varying multidimensional construct with ill-defined dimension-specific and age-specific effects on brain and behavior. We investigated these effects in 4,228 young adults. From 16 socioeconomic indicators, assessed for early (0-10 years) and late (>10 years) stages, we constructed family, provincial, family adverse and neighborhood adverse socioeconomic dimensions. Generally, family SES was associated with brain structure and connectivity along with cognitive function, whereas family adverse and neighborhood adverse SES were associated with personality and emotion. Most associations were observed for both early and late-stage SES; however, adjusting for the effect of early stage SES revealed late-stage-specific SES effects. Changes in SES were associated with personality and cognitive function. Cerebellar and medial frontal volumes and functional connectivity within the left frontoparietal network mediated the associations between family SES and memory and openness. These results inform both more precise interventions for reducing the consequences of adverse SES and experimental designs for excluding confounding socioeconomic effects on human health.
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Affiliation(s)
- Qiang Xu
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, and State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Su Lui
- Department of Radiology, the Center for Medical Imaging, West China Hospital of Sichuan University, Chengdu, China
| | - Yuan Ji
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, and State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Long Jiang Zhang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Bing Zhang
- Department of Radiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zuojun Geng
- Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guangbin Cui
- Functional and Molecular Imaging Key Lab of Shaanxi Province & Department of Radiology, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Quan Zhang
- Department of Radiology, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin, China
| | - Weihua Liao
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
- Molecular Imaging Research Center of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hui Zhang
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Bo Gao
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
- Department of Radiology, Yantai Yuhuangding Hospital, Yantai, China
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Tong Han
- Department of Radiology, Tianjin Huanhu Hospital, Tianjin, China
| | - Zhenwei Yao
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wen Qin
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, and State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Feng Liu
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, and State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Meng Liang
- School of Medical Imaging and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University, Tianjin, China
| | - Jilian Fu
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, and State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiayuan Xu
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, and State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Peng Zhang
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Wei Li
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Dapeng Shi
- Department of Radiology, Henan Provincial People's Hospital & Zhengzhou University People's Hospital, Zhengzhou, China
| | - Caihong Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jia-Hong Gao
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Zhihan Yan
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Feng Chen
- Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China
| | - Jiance Li
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jing Zhang
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, China
| | - Dawei Wang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Wen Shen
- Department of Radiology, Tianjin First Center Hospital, Tianjin, China
| | - Yanwei Miao
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Junfang Xian
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Meiyun Wang
- Department of Radiology, Henan Provincial People's Hospital & Zhengzhou University People's Hospital, Zhengzhou, China
| | - Zhaoxiang Ye
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Xiaochu Zhang
- Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China
| | - Xi-Nian Zuo
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Kai Xu
- Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
| | - Shijun Qiu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, China.
| | - Chunshui Yu
- Department of Radiology, Tianjin Key Laboratory of Functional Imaging, and State Key Laboratory of Experimental Hematology, Tianjin Medical University General Hospital, Tianjin, China.
- CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China.
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Liu C, Gershon ES. Endophenotype 2.0: updated definitions and criteria for endophenotypes of psychiatric disorders, incorporating new technologies and findings. Transl Psychiatry 2024; 14:502. [PMID: 39719446 PMCID: PMC11668880 DOI: 10.1038/s41398-024-03195-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2024] [Revised: 11/28/2024] [Accepted: 12/05/2024] [Indexed: 12/26/2024] Open
Abstract
Recent genetic studies have linked numerous loci to psychiatric disorders. However, the biological pathways that connect these genetic associations to psychiatric disorders' specific pathophysiological processes are largely unclear. Endophenotypes, first defined over five decades ago, are heritable traits, independent of disease state that are associated with a disease, encompassing a broad range of neurophysiological, biochemical, endocrinological, neuroanatomical, cognitive, and neuropsychological characteristics. Considering the advancements in genetics and genomics over recent decades, we propose a revised definition of endophenotypes as 'genetically influenced phenotypes linked to disease or treatment characteristics and their related events.' We also updated endophenotype criteria to include (1) reliable measurement, (2) association with the disease or its related events, and (3) genetic mediation. 'Genetic mediation' is introduced to differentiate between causality and pleiotropic effects and allows non-linear relationships. Furthermore, this updated Endophenotype 2.0 framework expands to encompass genetically regulated responses to disease-related factors, including environmental risks, illness progression, treatment responses, and resilience phenotypes, which may be state-dependent. This broadened definition paves the way for developing new endophenotypes crucial for genetic analyses in psychiatric disorders. Integrating genetics, genomics, and diverse endophenotypes into multi-dimensional mechanistic models is vital for advancing our understanding of psychiatric disorders. Crucially, elucidating the biological underpinnings of endophenotypes will enhance our grasp of psychiatric genetics, thereby improving disease risk prediction and treatment approaches.
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Affiliation(s)
- Chunyu Liu
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA.
- School of Life Sciences, Central South University, Changsha, China.
| | - Elliot S Gershon
- Departments of Psychiatry and Human Genetics, The University of Chicago, Chicago, IL, USA.
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Scholte-Stalenhoef AN, Pijnenborg GHM, Hasson-Ohayon I, Boyette LL. Personality traits in psychotic illness and their clinical correlates: A systematic review. Schizophr Res 2023; 252:348-406. [PMID: 36804473 DOI: 10.1016/j.schres.2023.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 12/18/2022] [Accepted: 01/02/2023] [Indexed: 02/17/2023]
Abstract
This systematic review focuses on personality traits according to both the Five Factor Model and Cloninger Psychobiological Model in relation to treatment related outcome variables across all stages of clinical psychotic illness. Search of Pubmed and Psychinfo databases led to final inclusion of 65 studies, which were ranked on quality and analyzed according to the associations between personality and outcome. Main findings are that higher levels of Harm Avoidance and Neuroticism are associated with higher symptom levels, tendency towards passive coping, greater self-stigma, lower quality of life, and Harm Avoidance to higher suicidality. Higher levels of Extraversion and higher levels of Self-Directedness are associated with more preference for active coping, more intrinsic motivation and higher self-esteem. Higher Novelty Seeking is related to more substance use and aggression, in men specifically. On outcome of trauma, care consumption and duration of untreated illness no consistent associations with personality traits were found. Combined evidence from both personality models however reveals a consistent pattern of personality traits related to clinical outcome in psychotic disorder, which is discussed in a dimensional manner.
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Affiliation(s)
- Anne Neeltje Scholte-Stalenhoef
- Ziekenhuis Groep Twente, Department of Psychiatry, Almelo, the Netherlands; University of Groningen, Department of Psychology, Groningen, the Netherlands.
| | | | | | - Lindy-Lou Boyette
- University of Amsterdam, Department of Clinical Psychology, Amsterdam, the Netherlands
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Gumley AI, Bradstreet S, Ainsworth J, Allan S, Alvarez-Jimenez M, Birchwood M, Briggs A, Bucci S, Cotton S, Engel L, French P, Lederman R, Lewis S, Machin M, MacLennan G, McLeod H, McMeekin N, Mihalopoulos C, Morton E, Norrie J, Reilly F, Schwannauer M, Singh SP, Sundram S, Thompson A, Williams C, Yung A, Aucott L, Farhall J, Gleeson J. Digital smartphone intervention to recognise and manage early warning signs in schizophrenia to prevent relapse: the EMPOWER feasibility cluster RCT. Health Technol Assess 2022; 26:1-174. [PMID: 35639493 DOI: 10.3310/hlze0479] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Relapse is a major determinant of outcome for people with a diagnosis of schizophrenia. Early warning signs frequently precede relapse. A recent Cochrane Review found low-quality evidence to suggest a positive effect of early warning signs interventions on hospitalisation and relapse. OBJECTIVE How feasible is a study to investigate the clinical effectiveness and cost-effectiveness of a digital intervention to recognise and promptly manage early warning signs of relapse in schizophrenia with the aim of preventing relapse? DESIGN A multicentre, two-arm, parallel-group cluster randomised controlled trial involving eight community mental health services, with 12-month follow-up. SETTINGS Glasgow, UK, and Melbourne, Australia. PARTICIPANTS Service users were aged > 16 years and had a schizophrenia spectrum disorder with evidence of a relapse within the previous 2 years. Carers were eligible for inclusion if they were nominated by an eligible service user. INTERVENTIONS The Early signs Monitoring to Prevent relapse in psychosis and prOmote Wellbeing, Engagement, and Recovery (EMPOWER) intervention was designed to enable participants to monitor changes in their well-being daily using a mobile phone, blended with peer support. Clinical triage of changes in well-being that were suggestive of early signs of relapse was enabled through an algorithm that triggered a check-in prompt that informed a relapse prevention pathway, if warranted. MAIN OUTCOME MEASURES The main outcomes were feasibility of the trial and feasibility, acceptability and usability of the intervention, as well as safety and performance. Candidate co-primary outcomes were relapse and fear of relapse. RESULTS We recruited 86 service users, of whom 73 were randomised (42 to EMPOWER and 31 to treatment as usual). Primary outcome data were collected for 84% of participants at 12 months. Feasibility data for people using the smartphone application (app) suggested that the app was easy to use and had a positive impact on motivations and intentions in relation to mental health. Actual app usage was high, with 91% of users who completed the baseline period meeting our a priori criterion of acceptable engagement (> 33%). The median time to discontinuation of > 33% app usage was 32 weeks (95% confidence interval 14 weeks to ∞). There were 8 out of 33 (24%) relapses in the EMPOWER arm and 13 out of 28 (46%) in the treatment-as-usual arm. Fewer participants in the EMPOWER arm had a relapse (relative risk 0.50, 95% confidence interval 0.26 to 0.98), and time to first relapse (hazard ratio 0.32, 95% confidence interval 0.14 to 0.74) was longer in the EMPOWER arm than in the treatment-as-usual group. At 12 months, EMPOWER participants were less fearful of having a relapse than those in the treatment-as-usual arm (mean difference -4.29, 95% confidence interval -7.29 to -1.28). EMPOWER was more costly and more effective, resulting in an incremental cost-effectiveness ratio of £3041. This incremental cost-effectiveness ratio would be considered cost-effective when using the National Institute for Health and Care Excellence threshold of £20,000 per quality-adjusted life-year gained. LIMITATIONS This was a feasibility study and the outcomes detected cannot be taken as evidence of efficacy or effectiveness. CONCLUSIONS A trial of digital technology to monitor early warning signs that blended with peer support and clinical triage to detect and prevent relapse is feasible. FUTURE WORK A main trial with a sample size of 500 (assuming 90% power and 20% dropout) would detect a clinically meaningful reduction in relapse (relative risk 0.7) and improvement in other variables (effect sizes 0.3-0.4). TRIAL REGISTRATION This trial is registered as ISRCTN99559262. FUNDING This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 27. See the NIHR Journals Library website for further project information. Funding in Australia was provided by the National Health and Medical Research Council (APP1095879).
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Affiliation(s)
- Andrew I Gumley
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Simon Bradstreet
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - John Ainsworth
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Stephanie Allan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Mario Alvarez-Jimenez
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Maximillian Birchwood
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Andrew Briggs
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sandra Bucci
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Sue Cotton
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Lidia Engel
- School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| | - Paul French
- Department of Nursing, Manchester Metropolitan University, Manchester, UK
| | - Reeva Lederman
- School of Computing and Information Systems, Melbourne School of Engineering, University of Melbourne, Melbourne, VIC, Australia
| | - Shôn Lewis
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Matthew Machin
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Graeme MacLennan
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Hamish McLeod
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nicola McMeekin
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Cathy Mihalopoulos
- School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| | - Emma Morton
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - John Norrie
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | | | - Swaran P Singh
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Suresh Sundram
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Andrew Thompson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia.,Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Chris Williams
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Alison Yung
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Lorna Aucott
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - John Farhall
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia.,NorthWestern Mental Health, Melbourne, VIC, Australia
| | - John Gleeson
- Healthy Brain and Mind Research Centre, Australian Catholic University, Melbourne, VIC, Australia
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Cowan HR, Mittal VA, Allen DN, Gold JM, Strauss GP. Heterogeneity of emotional experience in schizophrenia: Trait affect profiles predict clinical presentation and functional outcome. JOURNAL OF ABNORMAL PSYCHOLOGY 2020; 129:760-767. [PMID: 32584084 DOI: 10.1037/abn0000554] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The current study examined whether subgroups of individuals with schizophrenia could be identified based on their profiles of trait positive and negative emotional experience, and whether those subgroups differed in their symptom presentation and functional outcome. Participants included 192 outpatients diagnosed with schizophrenia or schizoaffective disorder (SZ) and 149 demographically matched healthy controls who completed the trait version of the Positive and Negative Affect Scale, as well as symptom and functional outcome assessments. Cluster analysis determined whether patients could be separated into meaningful subgroups based on their trait emotional experience profiles, and discriminant function analysis determined whether these groups were valid and adequately separated. Forty-two percent of the patients fell into an affectively normal cluster, whereas 28% and 30% fell into low positive affect (PA) and high negative affect (NA) clusters, respectively. These subgroups differed significantly on positive symptoms, negative symptoms, Diagnostic and Statistical Manual of Mental Disorders diagnoses, and functional outcomes. Trait emotional experience is heterogeneous in outpatients with psychotic disorders, and meaningful subgroups of patients with different profiles of PA and NA can be identified. These subgroups show meaningful differences in clinical presentation, which may necessitate different treatment approaches. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Uchino T, Nemoto T, Yamaguchi T, Katagiri N, Tsujino N, Murakami Y, Tanaka K, Mizuno M. Associations Of Personality Traits With The Capacity-Performance Discrepancy Of Functional Outcome In Patients With Schizophrenia. Neuropsychiatr Dis Treat 2019; 15:2869-2877. [PMID: 31632034 PMCID: PMC6781607 DOI: 10.2147/ndt.s218738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/13/2019] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE Functional capacity, which indicates one's ability to perform everyday living tasks, contributes to real-world functional performance in patients with schizophrenia. However, functional capacity is sometimes not comparable with functional performance in clinical settings. We hypothesized that specific personality traits are related to this capacity-performance discrepancy of functional outcome. METHODS The measures in this study were the UCSD Performance-based Skills Assessment Brief (UPSA-B) for functional capacity, the Social Functioning Scale (SFS) for functional performance, and the Temperament and Character Inventory-140 (TCI-140) for personality traits. A total of 94 stable outpatients with schizophrenia were divided into four groups based on combinations of their UPSA-B and SFS cut-off points, as follows: a high capacity and high performance (HH) group, a high capacity but low performance (HL) group, a low capacity but high performance (LH) group, and a low capacity and low performance (LL) group. RESULTS There were no significant differences in demographics among the four groups. The LH group showed a significantly lower harm avoidance level than the LL group. The HL group showed a significantly lower persistence level than the HH group. CONCLUSION Lower harm avoidance may enhance functional performance, and lower persistence can limit functional performance, regardless of the primary levels of functional capacity in patients with schizophrenia. Novel and individualized psychosocial treatments considering the individual's personality traits seem to be helpful for maximizing their functional performance in the community.
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Affiliation(s)
- Takashi Uchino
- Department of Neuropsychiatry, Toho University Graduate School of Medicine, Tokyo 143-8540, Japan.,Tokyo Adachi Hospital, Tokyo 121-0064, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University Graduate School of Medicine, Tokyo 143-8540, Japan
| | - Taiju Yamaguchi
- Department of Neuropsychiatry, Toho University Graduate School of Medicine, Tokyo 143-8540, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University Graduate School of Medicine, Tokyo 143-8540, Japan
| | - Naohisa Tsujino
- Department of Neuropsychiatry, Toho University Graduate School of Medicine, Tokyo 143-8540, Japan
| | - Yoshitaka Murakami
- Department of Medical Statistics, Toho University School of Medicine, Tokyo 143-8540, Japan
| | | | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University Graduate School of Medicine, Tokyo 143-8540, Japan
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7
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Seo E, Bang M, Lee E, An SK. Aberrant Tendency of Noncurrent Emotional Experiences in Individuals at Ultra-High Risk for Psychosis. Psychiatry Investig 2018; 15:876-883. [PMID: 30176705 PMCID: PMC6166032 DOI: 10.30773/pi.2018.07.29.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 07/29/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aimed to investigate whether aberrant tendency of noncurrent emotion was present in individuals at ultra-high risk (UHR) for psychosis and to explore its associations with various clinical profiles. METHODS Fifty-seven individuals at UHR and 49 normal controls were enrolled. The tendency of experiencing noncurrent emotion was assessed using various noncurrent emotional self-reported formats, including trait [Neuroticism and Extraversion of the Eysenck Personality Questionnaire], hypothetical (Chapman's Revised Physical and Social Anhedonia Scales), and retrospective [AnhedoniaAsociality Subscale of the Scale for the Assessment of Negative Symptoms (SANS)] measures. Self-related beliefs (Self-Perception Scale), clinical positive and negative symptoms (SA Positive Symptoms and SANS), psychosocial function (Global Functioning Scale: Role Function and Global Functioning Scale: Social Function) were also examined. RESULTS Subjects at UHR for psychosis reported more trait unpleasant and less trait pleasant emotions, more hypothetical physical and social anhedonia, and more retrospective anhedonia than normal controls. In UHR, self-perception was correlated to trait unpleasant emotion and hypothetical physical and social anhedonia. Negative symptoms in UHR were associated with hypothetical physical anhedonia and retrospective anhedonia. Global social functioning was related to trait pleasant emotion, hypothetical physical and social anhedonia, and retrospective anhedonia. Neurocognitive function, positive symptoms, and global role functioning were not related with any noncurrent emotional experience measures in UHR. CONCLUSION These findings suggest that the aberrant tendency of noncurrent emotional experience may be present at the 'putative' prodromal phase and are grossly associated with self-related beliefs and psychosocial functioning but not neurocognitive functioning.
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Affiliation(s)
- Eunchong Seo
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea.,Section of Self, Affect, and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minji Bang
- Section of Self, Affect, and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Eun Lee
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea.,Section of Self, Affect, and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk Kyoon An
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea.,Section of Self, Affect, and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Graduate Program in Cognitive Science, Yonsei University, Seoul, Republic of Korea
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8
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Shi J, Yao Y, Zhan C, Mao Z, Yin F, Zhao X. The Relationship Between Big Five Personality Traits and Psychotic Experience in a Large Non-clinical Youth Sample: The Mediating Role of Emotion Regulation. Front Psychiatry 2018; 9:648. [PMID: 30564151 PMCID: PMC6288374 DOI: 10.3389/fpsyt.2018.00648] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 11/16/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: Despite a long history of interest in personality traits and psychosis, the association between personality traits and psychotic experiences in the general population is not yet well understood. One possible factor that could influence the degree of distress from psychotic experiences is emotion regulation. The purpose of this study was to explore whether the association between personality and psychotic symptoms is already apparent in non-clinical youth as well as the mediating role of emotion regulation strategies between personality traits and psychotic experiences. Methods: Three thousand one hundred and forty seven college students were surveyed via self-report questionnaires measuring the Five-Factor model of personality, emotion regulation strategies, and psychotic experiences. Results: Neuroticism was found to be significantly positively correlated with psychotic experiences, while Extraversion, Openness, Agreeableness, and Conscientiousness were found to be significantly negatively correlated. Both the suppression and reappraisal strategies mediated the relationship between personality traits and psychotic experiences. Conclusion: Our findings suggest that youth with certain personality traits are more likely to have psychotic experiences. The reappraisal emotion regulation strategy could serve as a protective factor against the distress of psychotic experiences.
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Affiliation(s)
- Jingyu Shi
- Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.,Division of Medical Humanities & Behavioral Sciences, Tongji University School of Medicine, Shanghai, China
| | - Yuhong Yao
- Students Counseling Center, Tongji University, Shanghai, China
| | - Chenyu Zhan
- Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ziyu Mao
- Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Fang Yin
- Students Counseling Center, Tongji University, Shanghai, China
| | - Xudong Zhao
- Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.,Division of Medical Humanities & Behavioral Sciences, Tongji University School of Medicine, Shanghai, China
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The associations between childhood trauma, neuroticism and comorbid obsessive-compulsive symptoms in patients with psychotic disorders. Psychiatry Res 2017; 254:48-53. [PMID: 28448804 DOI: 10.1016/j.psychres.2017.04.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 02/21/2017] [Accepted: 04/18/2017] [Indexed: 11/21/2022]
Abstract
Various studies reported remarkably high prevalence rates of obsessive-compulsive symptoms (OCS) in patients with a psychotic disorder. Little is known about the pathogenesis of this co-occurrence. The current study aimed to investigate the contribution of shared underlying risk factors, such as childhood trauma and neuroticism, to the onset and course of OCS in patients with psychosis. Data were retrieved from 161 patients with psychosis included in the 'Genetic Risk and Outcome in Psychosis' project. Patients completed measures of OCS and psychotic symptoms at study entrance and three years later. Additionally, childhood maltreatment and neuroticism were assessed. Between-group comparisons revealed increased neuroticism and positive symptoms in patients who reported comorbid OCS compared to OCS-free patients. Subsequent mediation analyses suggested a small effect of childhood abuse on comorbid OCS severity at baseline, which was mediated by positive symptom severity. Additionally, results showed a mediating effect of neuroticism as well as a moderating effect of positive symptoms on the course of OCS severity over time. OCS severity in patients with psychosis might thus be associated with common vulnerability factors, such as childhood abuse and neuroticism. Furthermore, the severity of positive symptoms might be associated with more severe or persistent comorbid OCS.
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10
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Smeland OB, Wang Y, Lo MT, Li W, Frei O, Witoelar A, Tesli M, Hinds DA, Tung JY, Djurovic S, Chen CH, Dale AM, Andreassen OA. Identification of genetic loci shared between schizophrenia and the Big Five personality traits. Sci Rep 2017; 7:2222. [PMID: 28533504 PMCID: PMC5440373 DOI: 10.1038/s41598-017-02346-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 04/10/2017] [Indexed: 11/25/2022] Open
Abstract
Schizophrenia is associated with differences in personality traits, and recent studies suggest that personality traits and schizophrenia share a genetic basis. Here we aimed to identify specific genetic loci shared between schizophrenia and the Big Five personality traits using a Bayesian statistical framework. Using summary statistics from genome-wide association studies (GWAS) on personality traits in the 23andMe cohort (n = 59,225) and schizophrenia in the Psychiatric Genomics Consortium cohort (n = 82,315), we evaluated overlap in common genetic variants. The Big Five personality traits neuroticism, extraversion, openness, agreeableness and conscientiousness were measured using a web implementation of the Big Five Inventory. Applying the conditional false discovery rate approach, we increased discovery of genetic loci and identified two loci shared between neuroticism and schizophrenia and six loci shared between openness and schizophrenia. The study provides new insights into the relationship between personality traits and schizophrenia by highlighting genetic loci involved in their common genetic etiology.
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Affiliation(s)
- Olav B Smeland
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway.
| | - Yunpeng Wang
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
- Department of Neurosciences, University of California San Diego, La Jolla, CA, 92093, United States of America
| | - Min-Tzu Lo
- Department of Radiology, University of California, San Diego, La Jolla, CA, 92093, United States of America
| | - Wen Li
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
| | - Oleksandr Frei
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
| | - Aree Witoelar
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
| | - Martin Tesli
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway
- Lovisenberg Diakonale Hospital, 0456, Oslo, Norway
| | - David A Hinds
- 23andMe, Inc., Mountain View, CA, 94041, United States of America
| | - Joyce Y Tung
- 23andMe, Inc., Mountain View, CA, 94041, United States of America
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Chi-Hua Chen
- Department of Radiology, University of California, San Diego, La Jolla, CA, 92093, United States of America
| | - Anders M Dale
- Department of Neurosciences, University of California San Diego, La Jolla, CA, 92093, United States of America
- Department of Radiology, University of California, San Diego, La Jolla, CA, 92093, United States of America
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, 0407, Oslo, Norway.
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11
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Personality and coping in first episode psychosis linked to mental health care use. Psychiatry Res 2016; 238:218-224. [PMID: 27086236 DOI: 10.1016/j.psychres.2016.02.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 02/03/2016] [Accepted: 02/16/2016] [Indexed: 12/24/2022]
Abstract
A body of literature focuses on associations of neuroticism, extraversion, passive coping and active coping with the course of psychotic illness. Less is known about other personality and coping variables - and underlying causal mechanisms between variables remain unclear. We explored causal effects from personality, coping and symptoms on mental health care consumption over two years in 208 first episode patients. Causal inference search algorithms lead to formation of a hypothetical causal model based on presumptions on (non-)mutuality between variables and consistent with data. Structural equation modelling estimated effect sizes conditionally on the causal model. Our observed model implies that none of the coping or personality variables have any effect on the number of days of hospitalisation, whereas general psychopathology symptoms do have a direct positive effect. For ambulatory care it is proposed that openness to experience, depressive symptoms and age have direct positive effects. Reassuring thoughts as a coping strategy seems to have a direct negative effect on the use of ambulatory care and mediates indirect effects of other personality and coping variables on ambulatory care. Furthermore, while previously established relations between personality and symptoms are confirmed by our model, it challenges traditional ideas about causation between personality and symptoms.
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12
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Compton MT, Bakeman R, Alolayan Y, Balducci PM, Bernardini F, Broussard B, Crisafio A, Cristofaro S, Amar P, Johnson S, Wan CR. Personality domains, duration of untreated psychosis, functioning, and symptom severity in first-episode psychosis. Schizophr Res 2015; 168:113-9. [PMID: 26209478 PMCID: PMC4929617 DOI: 10.1016/j.schres.2015.06.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 06/24/2015] [Accepted: 06/29/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Early-course psychotic disorders have been extensively studied in terms of phenomenology, but little is known about the influence of personality traits on clinical features of first-episode psychosis. The aim of this study was to explore how the "big five" personality domains (neuroticism, extraversion, openness, agreeableness, and conscientiousness) are associated with treatment delay (duration of untreated psychosis, DUP), functioning, and positive and negative symptom severity. METHODS Data for these analyses were obtained from 104 participants enrolled from psychiatric inpatient units in Atlanta, Georgia, between August 2008 and March 2011. The NEO Five-Factor Inventory (NEO-FFI) was used to assess personality domains, and all other variables were measured in a standardized and rigorous manner using psychometrically sound instruments. Correlational analyses and multiple linear regressions were carried out to examine the strength of associations between variables of interest. RESULTS Findings indicated that except for openness, all of the other personality variables contributed to some extent to the variance in DUP. Conscientiousness was positively correlated with functioning. Agreeableness was independently negatively associated with positive symptom severity and extraversion was independently negatively correlated with negative symptom severity. CONCLUSIONS We report the first evidence suggesting that DUP is in part driven by personality domains. Functioning and symptom severity are also associated with those domains. Personality should be taken into account in order to better understand the phenomenology of early-course psychotic disorders as well as treatment-seeking behaviors.
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Affiliation(s)
- Michael T Compton
- Lenox Hill Hospital, Department of Psychiatry, New York, NY, USA; Hofstra North Shore-LIJ School of Medicine at Hofstra University, Department of Psychiatry, Hempstead, NY, USA.
| | - Roger Bakeman
- Georgia State University, Department of Psychology, Atlanta, GA, USA
| | - Yazeed Alolayan
- The George Washington University School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Sciences, Washington, DC, USA
| | - Pierfrancesco Maria Balducci
- Lenox Hill Hospital, Department of Psychiatry, New York, NY, USA; Scuola di Specializzazione in Psichiatria, Dipartimento di Medicina, Università degli Studi di Perugia, Italy
| | - Francesco Bernardini
- Lenox Hill Hospital, Department of Psychiatry, New York, NY, USA; Scuola di Specializzazione in Psichiatria, Dipartimento di Medicina, Università degli Studi di Perugia, Italy
| | - Beth Broussard
- Lenox Hill Hospital, Department of Psychiatry, New York, NY, USA
| | - Anthony Crisafio
- The George Washington University School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Sciences, Washington, DC, USA
| | - Sarah Cristofaro
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Patrick Amar
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Stephanie Johnson
- Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Claire Ramsay Wan
- Tufts University School of Medicine, Physician Assistant Program, Boston, MA, USA
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Boyette LL, Nederlof J, Meijer C, de Boer F, de Haan L. Three year stability of Five-Factor Model personality traits in relation to changes in symptom levels in patients with schizophrenia or related disorders. Psychiatry Res 2015; 229:539-44. [PMID: 26099654 DOI: 10.1016/j.psychres.2015.05.057] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 05/13/2015] [Accepted: 05/15/2015] [Indexed: 11/15/2022]
Abstract
Five-Factor Model (FFM) personality traits are related to a wide range of clinical outcome in patients with psychotic disorders. However, it is not sufficiently clear whether psychotic illness, particularly fluctuation in negative symptoms and psychotic relapse, affects personality. The current study examined the 3-year temporal stability of FFM traits in 91 patients with non-affective psychotic disorders with a maximum duration of illness of 10 years and 32 control subjects without a (family member with) a diagnosis of psychotic illness. In patients, change in negative symptoms predicted changes in Neuroticism and (inversely) in Extraversion and Openness. However, when correcting for depressive symptoms, negative symptoms no longer predicted change in any FFM trait. Clinical characteristics, such as psychotic relapse, were also not found to be related to change in FFM traits. Patients showed a slight increase in Conscientiousness levels, the other FFM traits showed mean-level stability. Rank-order stability of the FFM traits was moderate to strong, although weaker for Neuroticism in patients. Our findings indicate that psychotic symptoms exert limited effect on the stability of FFM traits in patients with psychotic disorders. Consistent with general population findings, one should guard against state-trait confusion between Neuroticism/Extraversion and depression.
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Affiliation(s)
- Lindy-Lou Boyette
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands.
| | - Jan Nederlof
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Carin Meijer
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Froukje de Boer
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
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Tao B, Xu S, Pan X, Gao Q, Wang W. Personality trait correlates of color preference in schizophrenia. Transl Neurosci 2015; 6:174-178. [PMID: 28123802 PMCID: PMC4936627 DOI: 10.1515/tnsci-2015-0018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 07/28/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The goal of the present study was to evaluate the color preferences of patients with schizophrenia and their correlations with personality traits. METHODOLOGY Sixty-three patients with schizophrenia and 59 healthy volunteers were asked to undertake the color preference and the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ) tests. RESULTS The healthy volunteers showed a greater preference for green but a lesser one for brown compared to the patients with schizophrenia. Patients scored higher than the healthy volunteers on the ZKPQ Neuroticism-Anxiety and Activity scales. Moreover, in patients, black preference ranking was associated with the Neuroticism-Anxiety, whereas pink and orange preferences were negatively associated with Activity; white preference correlated negatively with Sociability. CONCLUSIONS Patients with schizophrenia preferred green less but brown more, and displayed their personality correlates of these color preferences. These findings are suggesting that patients with schizophrenia should be encouraged to be more exposed to bright colors such as green and white, and less to dark colors such as black, during therapy and rehabilitation sessions.
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Affiliation(s)
- Baiping Tao
- Department of Clinical Psychology and Psychiatry / School of Public Health, Zhejiang University College of Medicine, Hangzhou, 310058, China
- The Third People’s Hospital of Huzhou, Huzhou, 313000, China
| | - Shaofang Xu
- Department of Clinical Psychology and Psychiatry / School of Public Health, Zhejiang University College of Medicine, Hangzhou, 310058, China
| | - Xin Pan
- The Third People’s Hospital of Huzhou, Huzhou, 313000, China
| | - Qianqian Gao
- Department of Clinical Psychology and Psychiatry / School of Public Health, Zhejiang University College of Medicine, Hangzhou, 310058, China
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry / School of Public Health, Zhejiang University College of Medicine, Hangzhou, 310058, China
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15
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McNeill SA, Galovski TE. Coping Styles Among Individuals with Severe Mental Illness and Comorbid PTSD. Community Ment Health J 2015; 51:663-73. [PMID: 26044653 DOI: 10.1007/s10597-015-9887-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 05/06/2015] [Indexed: 10/23/2022]
Abstract
There is little known about coping styles used by individuals with severe mental illness (SMI) and even less known about the influence of a comorbid posttraumatic stress disorder (SMI-PTSD) diagnosis on coping. The current study examines differences in utilization of coping strategies, overall psychological distress, and exposure to traumatic events between SMI only and SMI-PTSD individuals seeking community mental health clinic services (N = 90). Results demonstrate that overall psychological distress and use of avoidance coping were significantly higher among the SMI-PTSD sample. Avoidance coping partially mediated the relationship between PTSD symptom severity and psychological distress. Findings suggest that the experience of PTSD for those with SMI is associated with increases in avoidance coping, a coping style that significantly contributes to psychological distress. Implications for further study and treatment within community mental health clinics are considered.
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Affiliation(s)
- Shannon A McNeill
- Department of Psychology, University of Missouri - St. Louis, One University Blvd, St. Louis, MO, 63121, USA,
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16
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Peritogiannis V. Sensation/novelty seeking in psychotic disorders: A review of the literature. World J Psychiatry 2015; 5:79-87. [PMID: 25815257 PMCID: PMC4369552 DOI: 10.5498/wjp.v5.i1.79] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 12/31/2014] [Accepted: 01/19/2015] [Indexed: 02/05/2023] Open
Abstract
The evaluation of personality traits is important for the better understanding of the person suffering from psychosis and for treatment individualization. However literature on patients’ personality and character in such disorders is limited. The aim of this review was to summarize the literature on sensation/novelty seeking (SNS), a trait which is biologically based and highly heritable and is associated with dopamine activity, and refers to a person’s tendency to seek varied, novel, complex, and intense sensations and experiences. A total of 38 studies were included in this review, involving 2808 patients and 2039 healthy controls. There is consistent evidence that this trait is independently associated with alcohol and substance abuse in patients with schizophrenia and related disorders. The estimation of SNS would help clinicians to identify patients at risk for abuse. There is also some evidence that higher SNS levels may relate to medication non-adherence and seem to increase the risk of patients’ aggressive and violent behavior, but studies are scarce. SNS was found not to be related to suicidality, whereas in the fields of patients’ quality of life and psychopathology results are contradictory, but most studies show no possible association. Several studies suggest that SNS is lower in psychotic patients compared to controls, whereas most yield no differences. The evidence for this trait as a potential endophenotype of schizophrenia is weak. SNS may be implicated in psychotic disorders’ course and prognosis in several ways and should be always inquired for. This trait can be reliably measured with the use of easily applicable self-rated instruments, and patients’ accounts could inform clinicians when planning management and delivering individualized treatment.
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17
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Schirmbeck F, Boyette LL, van der Valk R, Meijer C, Dingemans P, Van R, de Haan L, Kahn RS, de Haan L, van Os J, Wiersma D, Bruggeman R, Cahn W, Meijer C, Myin-Germeys I. Relevance of Five-Factor Model personality traits for obsessive-compulsive symptoms in patients with psychotic disorders and their un-affected siblings. Psychiatry Res 2015; 225:464-70. [PMID: 25613659 DOI: 10.1016/j.psychres.2014.11.066] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 10/17/2014] [Accepted: 11/30/2014] [Indexed: 11/29/2022]
Abstract
High rates of obsessive-compulsive symptoms (OCS) in schizophrenia require pathogenic explanations. Personality traits may represent risk and resiliency factors for the development of mental disorders and their comorbidities. The aim of the present study was to explore the associations between Five-Factor Model (FFM) personality traits and the liability for OCS in patients with psychotic disorders and in their un-affected siblings. FFM traits, occurrence and severity of OCS and (subclinical) psychotic symptoms were assessed in 208 patients and in 281 siblings. Differences in FFM traits between participants with vs. without comorbid OCS were examined and the predictive value of FFM traits on group categorization was evaluated. Associations between FFM traits and OCS severity were investigated. Patients and siblings with OCS showed significantly higher Neuroticism compared to their counterparts without OCS. Neuroticism was positively associated with higher OCS severity and significantly predicted group assignment in both patients and in siblings. Patients with comorbid OCS presented with lower scores on Extraversion and Conscientiousness. Higher Neuroticism, and to a lesser degree lower Extraversion and Conscientiousness might add to the vulnerability of patients with a psychotic disorder to also develop OCS. Future prospective studies are needed to elucidate proposed personality-psychopathology interrelations and possible mediating factors.
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Affiliation(s)
- Frederike Schirmbeck
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands.
| | - Lindy-Lou Boyette
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | | | - Carin Meijer
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Peter Dingemans
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Rien Van
- Arkin Mental Health Department, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | | | - René S Kahn
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht The Netherlands
| | - Lieuwe de Haan
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Jim van Os
- Maastricht University Medical Center, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands
| | - Durk Wiersma
- University Medical Center Groningen, Department of Psychiatry, University of Groningen, The Netherlands
| | - Richard Bruggeman
- University Medical Center Groningen, Department of Psychiatry, University of Groningen, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht The Netherlands
| | - Carin Meijer
- Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Inez Myin-Germeys
- Maastricht University Medical Center, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands
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18
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Wiltink S, Nelson B, Velthorst E, Wigman J, Lin A, Baksheev G, Cosgrave E, Ross M, Ryan J, Yung A. The relationship between personality traits and psychotic like experiences in a large non-clinical adolescent sample. PERSONALITY AND INDIVIDUAL DIFFERENCES 2015. [DOI: 10.1016/j.paid.2014.09.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Eisner E, Barrowclough C, Lobban F, Drake R. Qualitative investigation of targets for and barriers to interventions to prevent psychosis relapse. BMC Psychiatry 2014; 14:201. [PMID: 25030092 PMCID: PMC4223366 DOI: 10.1186/1471-244x-14-201] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 07/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early signs based relapse prevention interventions for psychosis show promise. In order to examine how they might be improved we sought to better understand the early relapse process, service users' abilities to identify early signs, and any potential facilitators and barriers to early signs interventions. METHODS Data from in-depth interviews with a convenience sample of service users with psychosis varying in gender, age, duration of mental health problems, and time since last relapse were analysed using a thematic approach. Interview transcripts were coded inductively and relationships between emerging themes were examined by the research team to provide a thorough synthesis of the data. RESULTS Three central themes emerged from the analysis: 1) recognising risk factors (how risk factors were identified and linked to relapse, and reactions to such risk factors); 2) identifying early signs (issues related to both recognising and recalling signs of relapse); 3) reacting to deterioration (participants' thoughts and feelings in response to early signs, including help seeking and its challenges). CONCLUSIONS There was considerable variation in the attention participants had paid to pre-relapse signs, the ease with which they were able to recall them, and their reactions to them. For many, there were substantial barriers to help seeking from services. A family or friend confidant was an important means of assistance, although the supportive presence of significant others was not always available. Based on these results, a number of recommendations about facilitating service users' recognition of early signs and targeting potential accelerants of relapse are made.
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Affiliation(s)
- Emily Eisner
- Clinical Psychology Department, Zochonis Building (2nd Floor), University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Christine Barrowclough
- Clinical Psychology Department, Zochonis Building (2nd Floor), University of Manchester, Oxford Road, Manchester M13 9PL, UK
| | - Fiona Lobban
- Division of Health Research, Spectrum Centre for Mental Health Research, Furness building, University of Lancaster, Lancaster LA1 4YW, UK
| | - Richard Drake
- Institute of Brain Behaviour and Mental Health, Jean McFarlane Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK
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20
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Rocha N, Marques AJ, Queirós C, Rocha S. Proactive coping in schizophrenia: examining the impact of neurocognitive variables. J Psychiatr Ment Health Nurs 2014; 21:471-6. [PMID: 24654709 DOI: 10.1111/jpm.12141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- N Rocha
- Instituto Politécnico do Porto - Escola Superior de Tecnologia da Saúde, Porto, Portugal; Universidade do Porto - Faculdade de Psicologia e de Ciências da Educação, Porto, Portugal
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21
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Associations between the Five-Factor Model personality traits and psychotic experiences in patients with psychotic disorders, their siblings and controls. Psychiatry Res 2013; 210:491-7. [PMID: 23890697 DOI: 10.1016/j.psychres.2013.06.040] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 03/19/2013] [Accepted: 06/22/2013] [Indexed: 11/20/2022]
Abstract
Earlier studies indicated that personality characteristics contribute to symptomatic outcome in patients with psychotic disorders. The aim of the present study was to further explore this connection by examining the relationship between the Five-Factor Model (FFM) personality traits and a dimensional liability for psychosis. FFM traits according to the NEO-FFI and levels of subclinical psychotic symptoms according to the CAPE were assessed in 217 patients with psychotic disorders, 281 of their siblings and 176 healthy controls. Psychotic symptoms according to the PANSS were assessed in the patient group. Patients differed from siblings and controls on four of the five FFM traits, all but Openness. Siblings reported higher levels of Neuroticism than controls, but lower levels than patients. Particularly lower Agreeableness, and to a lesser degree, higher Neuroticism and lower Extraversion were associated with more severe symptoms in patients. Furthermore, higher Neuroticism and higher Openness were associated with higher levels of subclinical psychotic experiences in all three groups. Associations were strongest in patients. Our findings suggest that levels of Neuroticism increase with the level of familial risk for psychosis. Levels of Openness may reflect levels of impairment that distinguish clinical from subclinical symptomatology.
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22
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Johansen R, Melle I, Iversen VC, Hestad K. Personality traits, interpersonal problems and therapeutic alliance in early schizophrenia spectrum disorders. Compr Psychiatry 2013; 54:1169-76. [PMID: 23856387 DOI: 10.1016/j.comppsych.2013.05.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Revised: 05/16/2013] [Accepted: 05/22/2013] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND The quality of the therapeutic alliance is associated with engagement in- and thus important to the outcome of- treatment in schizophrenia. In non-psychotic disorders, general personality traits and individual patterns of interpersonal problems have been linked to the formation and quality of the therapeutic alliance. The role of these factors in relation to therapeutic alliance has not previously been explored in schizophrenia spectrum disorders. AIM To investigate associations between personality traits, interpersonal problems and the quality of the therapeutic alliance in early schizophrenia spectrum disorders. METHODS Demographic and clinical characteristics including Positive and Negative Syndrome Scale (PANSS) scores were assessed in 42 patients. Personality traits and interpersonal problems were assessed with the NEO Five factor Inventory (NEO-FFI) and the circumplex model of the Inventory of Interpersonal Problems (IIP-64C). Therapeutic alliance was measured with the Working Alliance Inventory - short form (WAI-S). RESULTS Patient WAI-S scores were predicted by IIP-64C Submissive/Hostile interpersonal problems, age and PANSS excitative symptoms. Therapist WAI-S scores were predicted by NEO-FFI Agreeableness and the PANSS insight item. CONCLUSION Core traits of personality and dimensions of interpersonal problems are associated with both patients' and therapists' perceptions of the quality of the working alliance.
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Affiliation(s)
- Ragnhild Johansen
- St. Olav's Hospital, Trondheim University Hospital, Forensic department Brøset Centre for Research and Education in Forensic Psychiatry, 7440 Trondheim, Norway; Dept of Psychology, The Norwegian University of Science and Technology, 7491 Trondheim, Norway.
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Vohs JL, Lysaker PH, Nabors L. Associations of personality with intrinsic motivation in schizophrenia. Psychiatry Res 2013; 208:78-80. [PMID: 23566367 DOI: 10.1016/j.psychres.2013.03.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 02/27/2013] [Accepted: 03/09/2013] [Indexed: 11/26/2022]
Abstract
Motivation is often disturbed in patients with schizophrenia, but little is known about how it relates to personality. We examined intrinsic motivation (IM), two personality domains from the NEO Five-Factor Inventory, and symptoms in 58 male patients with schizophrenia spectrum disorders. Analyses revealed IM may be linked to Extraversion, Neuroticism, and negative symptoms.
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Affiliation(s)
- Jenifer L Vohs
- Indiana University School of Medicine, Department of Psychiatry, Indianapolis, IN 46234, USA.
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Beauchamp MC, Lecomte T, Lecomte C, Leclerc C, Corbière M. Do personality traits matter when choosing a group therapy for early psychosis? Psychol Psychother 2013; 86:19-32. [PMID: 23386553 DOI: 10.1111/j.2044-8341.2011.02052.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study aimed at determining the predictive value of personality traits, based on the Five Factor Model (FFM) of personality, on therapeutic outcomes according to specific group treatments for first episode psychosis: cognitive-behavioural therapy (CBT) or skills training for symptom management (SM). METHODS Individuals experiencing early psychosis were recruited to participate in a randomized- controlled trial (RCT). Participants were randomized to one of two group treatments or to a wait-list control group. Measures included a personality inventory (NEO-FFI) and outcome measures of symptomatology (BPRS-E) and coping strategies (CCS). Pearson correlation analyses were conducted on 78 individuals and linear regression analyses on 66. RESULTS Links were found between personality traits, symptoms, and coping outcome measures, according to specific group treatments. Personality traits were particularly linked to therapeutic changes in active coping strategies, with Conscientiousness accounting for 14% of the variance in the CBT group, Extraversion accounting for 41% of the variance in the SM group, and Openness to experience accounting for 22% of the variance in the control group. CONCLUSIONS Individual differences in personality traits for people experiencing early psychosis should be considered when offering psychosocial treatments, since it appears that those with specific traits might benefit more than others in specific group interventions, particularly for interventions that do not solely aim at improving symptoms.
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Relationship between childhood adversity and clinical and cognitive features in schizophrenia. J Psychiatr Res 2012; 46:600-7. [PMID: 22329951 DOI: 10.1016/j.jpsychires.2012.01.023] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 01/18/2012] [Accepted: 01/19/2012] [Indexed: 11/21/2022]
Abstract
Childhood adversity is associated with elevated risk for a wide range of adult psychiatric disorders, and has significant and sustained negative effects on adult behavioural and social functioning. Elevated rates of childhood adversity have been reported for people with a diagnosis of schizophrenia. The aim of the present study was to assess rates of retrospectively reported childhood adversity among adults with schizophrenia and to examine the relationship between childhood adversity and clinical and cognitive features. Data were available for 408 schizophrenia participants and 267 healthy control participants recruited through the Australian Schizophrenia Research Bank (ASRB). History of childhood adversity was obtained using the Childhood Adversity Questionnaire (CAQ). A five-factor solution was identified from the CAQ. Schizophrenia participants reported experiencing more childhood adversities than controls. In both groups, those reporting childhood adversity were more likely to be female and older. Among participants with schizophrenia, positive symptom severity and fewer years of education were associated with childhood adversity. Lower IQ scores and personality traits were associated with reporting a greater number of childhood adversities and with adversity sub-types of abusive, neglectful and dysfunctional parenting. The rate of childhood adversity reported in this sample was high which suggests greater exposure to adverse childhood events among participants with schizophrenia in comparison with healthy controls. We identified unique groups amongst CAQ items that provided a salient framework from which to investigate the connection between childhood adversity and clinical and cognitive features.
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Bo S, Abu-Akel A, Kongerslev M, Haahr UH, Simonsen E. Risk factors for violence among patients with schizophrenia. Clin Psychol Rev 2011; 31:711-26. [PMID: 21497585 DOI: 10.1016/j.cpr.2011.03.002] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Revised: 02/24/2011] [Accepted: 03/02/2011] [Indexed: 10/18/2022]
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Brenner K, St-Hilaire A, Liu A, Laplante DP, King S. Cortisol response and coping style predict quality of life in schizophrenia. Schizophr Res 2011; 128:23-9. [PMID: 21353766 DOI: 10.1016/j.schres.2011.01.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 01/20/2011] [Accepted: 01/24/2011] [Indexed: 10/18/2022]
Abstract
Stress and coping have been found to be strongly associated with quality of life (QOL). Compared to community controls (CC), individuals diagnosed with schizophrenia (SZ) report a lower QOL. Lower QOL in SZ may be explained by patients' tendency to react differently to stress and to use less effective coping strategies than CC, but no studies to date have examined these possible associations. A main goal of this study, therefore, was to examine the roles of stress response and coping style in explaining QOL in SZ and CC, while controlling for potential confounds including personality. Subjects were 30 SZ patients and 29 matched controls who completed the Trier Social Stress Test (TSST). Salivary cortisol was used as an objective measure of stress response. Participants rated their coping strategies with the Brief COPE, judged their QOL with the Satisfaction with Life Scale, and rated their personality using the NEO-Five Factor Inventory. Results indicate that, even when confounds are controlled for, blunted cortisol response predicts better QOL in SZ patients. Additionally, results suggest that more frequent use of coping strategies is associated with better QOL but only in patients with blunted cortisol response; those who showed an increase in cortisol in response to the TSST have better QOL the lower their coping score. Possible explanations and clinical implications of these findings are discussed.
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Affiliation(s)
- Karene Brenner
- Université de Montréal, Département de Psychologie, 2900 Édouard-Montpetit Blvd., Montréal, QC, Canada H3T 1J4
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Campos MS, Garcia-Jalon E, Gilleen JK, David AS, Peralta MD V, Cuesta MJ. Premorbid personality and insight in first-episode psychosis. Schizophr Bull 2011; 37:52-60. [PMID: 20974749 PMCID: PMC3004187 DOI: 10.1093/schbul/sbq119] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Insight in psychosis and schizophrenia is considered a complex biopsychosocial phenomenon. Premorbid personality is regarded by some authors as part of the substrate to many psychiatric phenomena, but it is not clear if this applies to insight. AIM To examine longitudinal relationships between personality traits and insight dimensions in first-episode psychosis. METHODS One hundred consecutive antipsychotic-naïve first-episode nonaffective psychotic patients admitted to hospital were included in the study. Eighty-one patients completed at 1 month a premorbid personality evaluation, plus baseline, and 6-month insight assessments. We used the Assessment and Documentation of Psychopathology inventory for assessing insight dimensions (not feeling ill, lack of insight, and refusal of treatment) and the Personality Assessment Schedule for ascertaining 5 dimensions of premorbid personality (schizoid, passive-dependent, anancastic, sociopathic, and schizotypy). RESULTS At baseline, personality dimensions did not show any association with insight dimensions, with the exception of schizotypy traits. At 6 months, schizoid and sociopathic personality showed a significant association with not feeling ill (r = .30, P ≤ .007; r = .27, P = .01) and lack of insight (r = .36, P = .001; r = .41, P < .001), respectively. When we calculated insight change, schizoid and sociopathic personality had moderate correlation with the lack of insight dimension (r = -.34, P = .002; r = .38, P < .001, respectively). After applying partial correlations for potential confounders and Bonferroni correction, the associations remained significant. Moreover, using a regression model, sociopathic and schizoid personality significantly predicted lack of insight at 6 months and change from baseline to the 6 months assessment. CONCLUSIONS Sociopathic and schizoid personality dimensions were not only significantly associated with lack of insight at 6 months but also predicted change on lack of insight over 6 months. Therefore, exploring premorbid personality traits at the beginning of a psychotic episode may be helpful in identifying patients at high risk for lack of insight during the initial course of the illness.
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Affiliation(s)
- Maria S. Campos
- Psychiatric Unit of Virgen del Camino Hospital, c/Irunlarrea 4, E-31008 Pamplona, Spain
| | - Elena Garcia-Jalon
- Psychiatric Unit of Virgen del Camino Hospital, c/Irunlarrea 4, E-31008 Pamplona, Spain
| | - James K. Gilleen
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King’s College London, UK
| | - Anthony S. David
- Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King’s College London, UK
| | - Victor Peralta MD
- Psychiatric Unit of Virgen del Camino Hospital, c/Irunlarrea 4, E-31008 Pamplona, Spain
| | - Manuel J. Cuesta
- Psychiatric Unit of Virgen del Camino Hospital, c/Irunlarrea 4, E-31008 Pamplona, Spain,To whom correspondence should be addressed; tel: +34-848-422488, fax: +34-848-422488, e-mail:
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Traduction et validation française de l’échelle d’évaluation de la conscience des troubles mentaux des patients schizophrènes : The Scale to assess Unawareness of Mental Disorder (SUMD). Encephale 2010; 36:472-7. [DOI: 10.1016/j.encep.2009.12.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Accepted: 09/07/2009] [Indexed: 11/24/2022]
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Poustka L, Murray GK, Jääskeläinen E, Veijola J, Jones P, Isohanni M, Miettunen J. The influence of temperament on symptoms and functional outcome in people with psychosis in the Northern Finland 1966 Birth Cohort. Eur Psychiatry 2009; 25:26-32. [PMID: 19932601 DOI: 10.1016/j.eurpsy.2009.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2009] [Revised: 09/15/2009] [Accepted: 09/21/2009] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To describe symptom expression and functional outcome in psychotic disorders in relation with temperament traits assessed with the Temperament and Character Inventory (TCI) in a population-based sample. METHOD As part of the 31-year follow-up survey of the Northern Finland 1966 Birth Cohort, TCI temperament items were filled in by 4349 members of the cohort. In individuals with psychotic disorders, also positive and negative symptoms and outcome variables were assessed in a 35-year follow-up. Information of TCI and outcomes were available for altogether 41 individuals with psychosis. RESULT Reward dependence (RD) (rho=-0.45) and Persistence (P) (rho=-0.52) were significantly correlated with Positive and Negative Syndrome Scale (PANSS) negative symptoms. Higher P scores predicted higher social and occupational functioning (as measured by Social and Occupational Functioning Assessment Scale [SOFAS]), and higher Harm avoidance (HA) predicted a higher likelihood of being on a disability pension. CONCLUSION Results indicate that understanding of personality dimensions support better understanding of outcome and symptom expressions in psychotic disorders.
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Affiliation(s)
- L Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, J5, 68159 Mannheim, Germany.
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Lung FW, Shu BC, Chen PF. Personality and emotional response in schizophrenics with persistent auditory hallucination. Eur Psychiatry 2009; 24:470-5. [PMID: 19695846 DOI: 10.1016/j.eurpsy.2009.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Revised: 05/20/2009] [Accepted: 05/27/2009] [Indexed: 11/18/2022] Open
Abstract
Personality has been proposed as having a possible effect on the reaction that patients have toward auditory hallucination. However, this factor has not been studied previously. Thus, this study investigated the relationship among demographics, personality, cognition and emotional response in schizophrenics with persistent auditory hallucination. One-hundred and fourteen subjects with persistent auditory hallucination completed the Eysenck Personality Questionnaire, the revised Beliefs about Voices Questionnaire and the Chinese-version Hospital Anxiety and Depression Scale. Structural equation model showed that personality had an effect on beliefs about the hallucination (malevolent or benevolent), which then affected the reaction of patients toward these voices (engages or resists). Their reaction will further affect the anxious or depressed state of the patients. When these hallucinations were categorized into the three levels of omnipotence, beliefs and reactions, the model was more significant than that of one-level model. Persistent auditory hallucination only accounted for a portion of the emotional distress when malevolent or benevolent voices were perceived, and personality characteristics accounted for the remaining emotional distress in schizophrenics. This model helped us understand the relationship between personality, cognition and affective symptoms, such that, when therapists decide what "trait" to change, they can determine at which point to intervene.
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Affiliation(s)
- F-W Lung
- Department of Psychiatry, Kaohsiung Armed Forces General Hospital, N(o) 2 Chung Cheng 1(st) road, 802 Kaohsiung, Taiwan.
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Abstract
Studies of patients with schizophrenia or schizophrenia spectrum disorders and general population control groups consistently show differences regarding personality dimensions. However, the profile of personality dimensions in first-degree relatives of those patients is not well understood. We used Temperament and Character Inventory to explore personality dimensions in 61 clinically stable patients with schizophrenia or schizophrenia spectrum disorders, 59 of their first-degree relatives, and 64 healthy controls. Patients scored significantly higher than controls in harm avoidance and self-transcendence and lower in self-directedness and cooperativeness. First-degree relatives showed a tendency to lower novelty seeking and self-transcendence than controls. Interpretations of these findings include the possibility that lower novelty seeking and lower self-transcendence provide a protective influence in the relatives. Further studies are needed to go into this issue in greater depth.
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Bak M, Delespaul P, Krabbendam L, Huistra K, Walraven W, van Os J. Capturing coping with symptoms in people with a diagnosis of schizophrenia: introducing the MACS-24. Int J Methods Psychiatr Res 2009; 18:4-12. [PMID: 19195049 PMCID: PMC6878384 DOI: 10.1002/mpr.272] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In order to assess coping with psychotic symptoms, the Maastricht Assessment of Coping Strategies (MACS), 24 symptom version, was developed as a refinement of the previous MACS-13. Associations between type of coping and the experienced level of control over psychotic symptoms were examined using MACS-24.MACS-24 was administered to 32 individuals with a diagnosis of schizophrenia. For each of 24 symptoms, experience of distress, type of coping and the resulting degree of perceived control were assessed. Coping types were reduced to two contrasting coping factors: symptomatic coping and non-symptomatic coping (combining active problem solving, passive illness behaviour, active problem avoiding, and passive problem avoiding).Mean level of distress and perceived control (range: 1-7) were, respectively, 4.2 [standard deviation (SD) = 1.9] and 4.2 (SD = 1.9). The association between distress and perceived control was negative [beta = -0.28; 95% confidence interval (95%CI) = -0.41 to -0.15]. Type of coping interacted with perceived control (p = 0.005), in that symptomatic coping was negatively associated with perceived control [odds ratio (OR) over seven levels = 0.82, 95%CI = 0.71-0.94], whereas for non-symptomatic coping a positive association was apparent (OR over seven levels = 1.10, 95% CI = 1.03-1.19).Previous contrasts between symptomatic and non-symptomatic coping were replicated using MACS-24, suggesting clinical validity and utility.
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Affiliation(s)
- Maarten Bak
- Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, Euron, Maastricht University, Maastricht, The Netherlands.
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Abstract
This article reviews empirical studies of affective traits in individuals with schizophrenia spectrum disorders, population-based investigations of vulnerability to psychosis, and genetic and psychometric high-risk samples. The review focuses on studies that use self-report trait questionnaires to assess Negative Affectivity (NA) and Positive Affectivity (PA), which are conceptualized in contemporary models of personality as broad, temperamentally-based dispositions to experience corresponding emotional states. Individuals with schizophrenia report a pattern of stably elevated NA and low PA throughout the illness course. Among affected individuals, these traits are associated with variability in several clinically important features, including functional outcome, quality of life, and stress reactivity. Furthermore, evidence that elevated NA and low PA (particularly the facet of anhedonia) predict the development of psychosis and are detectable in high-risk samples suggests that these traits play a role in vulnerability to schizophrenia, though they are implicated in other forms of psychopathology as well. Results are discussed in terms of their implications for treatment, etiological models, and future research to advance the study of affective traits in schizophrenia and schizotypy.
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Affiliation(s)
- William P. Horan
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA 90095,To whom correspondence should be addressed; 300 UCLA Medical Plaza, Suite 2240, Los Angeles, CA 90095-6968, USA; tel: 310-206-8181, fax: 310-206-3651, e-mail:
| | - Jack J. Blanchard
- Department of Psychology, University of Maryland at College Park, College Park, MD 20742
| | - Lee Anna Clark
- Department of Psychology, University of Iowa, Iowa City, IA 52242
| | - Michael F. Green
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA 90095,VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073
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Dinzeo TJ, Cohen AS, Nienow TM, Docherty NM. Arousability in schizophrenia: relationship to emotional and physiological reactivity and symptom severity. Acta Psychiatr Scand 2008; 117:432-9. [PMID: 18397361 DOI: 10.1111/j.1600-0447.2008.01185.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Socioenvironmental stressors have been linked with increased symptom severity and relapse in those with schizophrenia. However, little is known about how individual differences in stress reactivity may contribute to these outcomes. METHOD This study examined the association between the temperament characteristic of arousability and changes in negative affect and cardiovascular activity during a challenge task in 58 in-patients with diagnosis of schizophrenia and 21 controls. RESULTS In the patient group, levels of arousability were significantly associated with increases in negative affect in response to the task and greater severity of affective symptoms. Levels of arousability were associated with decreased heart rate during the challenge task in our patient group. CONCLUSION These findings suggest that greater attention be given to individual differences, such as temperament and personality characteristics, and their role in the experience of stressors, including emotional and physiological response, as well as symptom development.
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Affiliation(s)
- T J Dinzeo
- Department of Psychology, Kent State University, Kent, OH, USA.
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36
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Couture S, Lecomte T, Leclerc C. Personality characteristics and attachment in first episode psychosis: impact on social functioning. J Nerv Ment Dis 2007; 195:631-9. [PMID: 17700294 DOI: 10.1097/nmd.0b013e31811f4021] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Research has suggested those with chronic schizophrenia are impaired in social functioning, and that those early in the illness also exhibit these impairments. However, the factors underlying and contributing to social dysfunction have not yet been well delineated, particularly within a first episode sample. The current study sought to investigate the role of attachment style and personality characteristics in the social dysfunction of those diagnosed with a first episode of psychosis. Ninety-six participants experiencing a first episode of psychosis were compared with control participants from 2 different samples on attachment and personality variables. Results suggested that those with a first episode of psychosis may experience more problematic attachment in peer relationships compared with nonclinical controls, and that the type and amount of differences observed may vary by gender. In addition, those experiencing a first episode of psychosis report different levels of the "big five" personality traits when compared with nonclinical controls. Finally, within the first episode sample, both personality and attachment appear to contribute variance to 3 domains of social functioning: social and individual living skills, inappropriate community behavior, and quality of life. These findings have implications for the functional significance of these psychological constructs.
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Affiliation(s)
- Shannon Couture
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Fresán A, Apiquian R, Nicolini H, Cervantes JJ. Temperament and character in violent schizophrenic patients. Schizophr Res 2007; 94:74-80. [PMID: 17509835 DOI: 10.1016/j.schres.2007.04.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2007] [Revised: 03/29/2007] [Accepted: 04/05/2007] [Indexed: 01/24/2023]
Abstract
UNLABELLED Preliminary evidence shows that personality traits are important in determining violent behavior in schizophrenia. As only some patients with schizophrenia show a greater risk for violence, this risk may therefore be considered as dynamic, varying as a function of the extent to which certain personality dimensions are present and the degree to which environmental events moderate or exacerbate their expression. OBJECTIVE To compare temperament and character dimensions between violent and non-violent schizophrenic patients and to determine which temperament and character dimensions are predictors of violent behavior in schizophrenia. METHOD We recruited 102 schizophrenic patients without concomitant substance abuse 4 months prior to the assessment. Diagnoses were based on the SCID-I. Personality dimensions were assessed with the Temperament and Character Inventory and violent behaviors with the Overt Aggression Scale. RESULTS Higher levels of the temperament dimension novelty seeking and a lower cooperativeness, as a character dimension, were risk factors for violent behavior in schizophrenic patients. DISCUSSION Our data indicate that schizophrenic patients will show a greater risk for violence according to certain personality configurations and the degree to which environmental events moderate or exacerbate their expression.
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Affiliation(s)
- A Fresán
- Clinical Research Division, National Institute of Psychiatry Ramón de la Fuente, Calz. México-Xochimilco 101, Mexico City, 14370 Mexico.
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Dinzeo TJ, Docherty NM. Normal personality characteristics in schizophrenia: a review of the literature involving the FFM. J Nerv Ment Dis 2007; 195:421-9. [PMID: 17502808 DOI: 10.1097/01.nmd.0000253795.69089.ec] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Schizophrenia is generally viewed as a disruption of normal functioning because of an underlying core illness. A number of theorists have speculated that this core illness may unilaterally disrupt normal personality functioning. However, recent data suggests that the relationship may be more complex and reciprocal than previously conceptualized. Furthermore, basic personality characteristics appear to be associated with numerous clinical phenomena. This article reviews the empirical literature pertaining to normal personality characteristics [structured around the five-factor model (FFM) of personality] in individuals with schizophrenia. Evidence suggests that certain personality characteristics may be uniquely related to the etiology of psychosis, as well as symptom severity, occupational functioning, cigarette smoking, substance use and violent behavior, social isolation, and suicidality in patients with schizophrenia. The implications of these findings and suggestions for future research are discussed.
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Affiliation(s)
- Thomas J Dinzeo
- Department of Psychology, Kent State University, Kent, Ohio 44240, USA.
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Köhler S, van Os J, de Graaf R, Vollebergh W, Verhey F, Krabbendam L. Psychosis risk as a function of age at onset: a comparison between early- and late-onset psychosis in a general population sample. Soc Psychiatry Psychiatr Epidemiol 2007; 42:288-94. [PMID: 17370045 PMCID: PMC1913178 DOI: 10.1007/s00127-007-0171-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2007] [Indexed: 11/27/2022]
Abstract
BACKGROUND Little is known about late-onset psychosis (onset after the age 45 years) and how it relates to early-onset psychosis (before age 45 years). The aims of this study were to calculate the incidence of non-affective, non-organic psychotic symptoms across the life span and to explore the contribution of different sets of risk factors in relation to age at onset. METHODS Data were obtained from the three measurements of the Netherlands Mental Health Survey and Incidence Study. Symptoms of psychosis were assessed in individuals aged 18-64 years using the Composite International Diagnostic Interview. All individuals reporting first-onset of psychotic symptoms within a three-year interval were included. The degree to which sets of risk factors affected the psychosis outcome similarly across age groups was assessed. RESULTS The number of subjects displaying incident psychotic symptoms was similar across age groups. Cumulative incidence rates ranged from 0.3% to 0.4%. Age differences were found for life-time depressive symptoms (risk difference = 5%, 95% CI = 1%, 9%) and baseline neuroticism (risk difference = 3%, 95% CI = 0%, 6%), indicating that late-onset psychosis was less often preceded by these. In contrast, no effect modification by age was observed for female sex, hearing impairment, being single, or life-time cannabis use. CONCLUSIONS Onset of psychotic symptoms in late life is no rare event. Compared to early onset psychosis, the late-onset counterpart less often arises in a context of emotional dysfunction and negative affectivity, suggesting qualitative differences in aetiology and more effective premorbid coping styles.
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Affiliation(s)
- Sebastian Köhler
- Dept. of Psychiatry and Neuropsychology, Sth Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, P.O. Box 616 (VIJV), 6200 MD Maastricht, The Netherlands
| | - Jim van Os
- Dept. of Psychiatry and Neuropsychology, Sth Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, P.O. Box 616 (VIJV), 6200 MD Maastricht, The Netherlands
- Division of Psychological Medicine, Institute of Psychiatry, London, UK
| | - Ron de Graaf
- The Netherlands Institute of Mental Health and Addiction, Trimbos-Institute Utrecht, Utrecht, The Netherlands
| | - Wilma Vollebergh
- The Netherlands Institute of Mental Health and Addiction, Trimbos-Institute Utrecht, Utrecht, The Netherlands
| | - Frans Verhey
- Dept. of Psychiatry and Neuropsychology, Sth Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, P.O. Box 616 (VIJV), 6200 MD Maastricht, The Netherlands
| | - Lydia Krabbendam
- Dept. of Psychiatry and Neuropsychology, Sth Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, P.O. Box 616 (VIJV), 6200 MD Maastricht, The Netherlands
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Ritsner MS, Blumenkrantz H. Predicting domain-specific insight of schizophrenia patients from symptomatology, multiple neurocognitive functions, and personality related traits. Psychiatry Res 2007; 149:59-69. [PMID: 17137634 DOI: 10.1016/j.psychres.2006.01.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2005] [Revised: 12/04/2005] [Accepted: 01/01/2006] [Indexed: 12/31/2022]
Abstract
This study examines the contribution of various neurocognitive functions, clinical characteristics, and personality traits to the prediction of three insight dimensions. Clinically stable schizophrenia patients (n=107) residing in the community were evaluated using the Positive and Negative Syndrome Scale, the Scale for the Assessment of Unawareness of Mental Disorder, and a comprehensive battery of instruments to measure personality related variables and neurocognitive functioning. Step-wise multivariate regression analysis indicates significant association of variability in insight dimensions with neurocognitive functioning (20-41%), personality related traits (8-18% temperament factors, 4-7% self-constructs, 10-14% coping styles), severity of symptoms (about 7%), illness duration (6%), and education (about 5%). Poor insight was attributed to impairment in visual and movement skills, sustained attention, executive functions, intensity of autistic preoccupations and positive symptoms, as well as increased novelty seeking behavior, task and emotion oriented coping styles, better self-esteem, self-efficacy, and higher education. Better awareness was related to better performance of neurocognitive tasks, reward dependence behavior, avoidant coping style, and longer illness duration. Aside from common indicators for the various insight dimensions, we defined specific indicators for each insight dimension. Thus, insight dimensions in schizophrenia patients residing in the community were attributed to neurocognitive and personality related factors rather than to psychopathological symptoms. The findings enable better understanding of the multifactorial nature of insight and highlight targets for more effective intervention and rehabilitation.
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Yanos PT, Moos RH. Determinants of functioning and well-being among individuals with schizophrenia: an integrated model. Clin Psychol Rev 2007; 27:58-77. [PMID: 16480804 PMCID: PMC1790965 DOI: 10.1016/j.cpr.2005.12.008] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Outcomes for health conditions are typically the result of multiple factors; however, studies tend to focus on a narrow class of variables. Functioning and well-being outcomes for schizophrenia are diverse and have resisted simple explanation; however, prior research has not offered an integrated understanding of the relative contributions of enduring and episodic environmental factors, personal resources and psychiatric factors, and cognitive appraisal and coping, on functioning and well-being outcomes in schizophrenia. The present article sets out an integrated model of the determinants of functioning and well-being among individuals with schizophrenia. To examine evidence that bears on the model, literature on hypothesized relationships is reviewed to identify areas for which there is strong evidence and areas where more research is needed. The article suggests areas for further research, and directs researchers and practitioners toward areas of intervention that can enhance functioning and well-being for persons diagnosed with schizophrenia.
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Affiliation(s)
- P T Yanos
- Rutgers University, Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ 08901, USA.
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Wickett A, Essman W, Beck-Jennings J, Davis L, McIlvried J, Lysaker PH. Cluster B and C personality traits, symptom correlates, and treatment utilization in postacute schizophrenia. J Nerv Ment Dis 2006; 194:650-3. [PMID: 16971815 DOI: 10.1097/01.nmd.0000235509.00780.85] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Unusually high levels of Cluster B and C personality traits have been observed in schizophrenia. While these have been linked to poorer function, less clear is the association of these personality traits with symptoms and service utilization. To examine this issue, 46 participants with schizophrenia or schizoaffective disorder were administered the Millon Clinical Multiaxial Inventory, Third Edition, and the Positive and Negative Syndrome Scale, and an inventory was taken of medical and psychiatric service utilization. Two sets of multiple regression analyses using Cluster B and C traits to predict treatment utilization and symptoms revealed that emotional discomfort symptoms were significantly related to level of borderline traits. Higher levels of positive symptoms were linked with more avoidant traits and fewer dependent traits. Higher levels of negative symptoms were linked with greater avoidant traits. Service utilization was predicted by borderline, antisocial, and avoidant traits. Implications for rehabilitation and treatment are discussed.
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Lysaker PH, Davis LW, Lightfoot J, Hunter N, Stasburger A. Association of neurocognition, anxiety, positive and negative symptoms with coping preference in schizophrenia spectrum disorders. Schizophr Res 2005; 80:163-71. [PMID: 16125370 DOI: 10.1016/j.schres.2005.07.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2005] [Revised: 07/03/2005] [Accepted: 07/07/2005] [Indexed: 11/30/2022]
Abstract
It is recognized that persons with schizophrenia tend to cope with stress in a relatively avoidant and ineffectual manner and that this coping style is linked to poorer outcome. Less is understood, however, about the interrelationship between symptoms, deficits in neurocognition and coping style in schizophrenia. To determine the extent to which various neurocognitive deficits and symptoms are related to coping style in schizophrenia, measures of positive symptoms, negative symptoms, state and trait anxiety levels, verbal memory and executive function were correlated with self-report of preference for a range of active and avoidant coping strategies. Participants were 42 persons with schizophrenia spectrum disorders enrolled in outpatient psychiatric care. Stepwise multiple regressions indicated that greater preferences for taking action when faced with a stressor were significantly (p<.05) linked to lesser positive symptoms and lesser state anxiety while greater preferences for thinking or talking about possible solutions were linked to lesser impairments in neurocognition. A greater preference for resigning in the face of stress was significantly linked to greater levels of negative symptoms and trait anxiety, while a preference to ignore stressors was linked to both greater levels of positive symptoms and graver impairments in neurocognition. Implications for understanding the genesis of psychosocial dysfunction and for the development of rehabilitative interventions are discussed.
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Affiliation(s)
- Paul H Lysaker
- Roudebush VA Medical Center, Day Hospital 116H, 1481 West 10th St, Roudebush VA Medical Center, Indianapolis, IN 46202, USA.
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Lysaker PH, Campbell K, Johannesen JK. Hope, awareness of illness, and coping in schizophrenia spectrum disorders: evidence of an interaction. J Nerv Ment Dis 2005; 193:287-92. [PMID: 15870611 DOI: 10.1097/01.nmd.0000161689.96931.0f] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Controversy exists regarding whether awareness of schizophrenia is linked with healthier or poorer psychosocial function. This study examined whether hope might interact with insight to affect function at the level of active versus avoidant coping preferences among 96 persons with schizophrenia spectrum disorders. Factorial multivariate analysis of variance comparing groups classified on the basis of hope and insight scores revealed a significant interaction between hope and insight (Wilks lambda = 2.7; p< 0.05). Post hoc analyses indicated that persons with high insight and high hope demonstrated the most adaptive coping preferences, whereas those with high insight and lower hope demonstrated the least.
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Affiliation(s)
- Paul H Lysaker
- Roudebush VA Medical Center, Indianapolis, Indiana 46202, USA
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Hofstetter JR, Lysaker PH, Mayeda AR. Quality of sleep in patients with schizophrenia is associated with quality of life and coping. BMC Psychiatry 2005; 5:13. [PMID: 15743538 PMCID: PMC554780 DOI: 10.1186/1471-244x-5-13] [Citation(s) in RCA: 103] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2004] [Accepted: 03/03/2005] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND While sleep disturbance is widespread in schizophrenia it is less clear whether sleep disturbance is uniquely related to impaired coping and perceived quality of life. METHODS We simultaneously assessed sleep quality, symptoms, and coping in 29 persons with schizophrenia or schizoaffective disorder in a post acute phase of illness. Assessment instruments included the Pittsburgh Sleep Quality Index; the Positive and Negative Symptom Scale; the Heinrichs Quality of Life Scale; and the Ways of Coping Scale. Multiple regressions were performed predicting quality of life and coping from sleep quality controlling for age and symptom severity. On a subset of seven subjects non-dominant wrist actigraphy was used as an objective check of their self-reported poor sleep. RESULTS Analyses revealed that poor sleep quality predicted low quality of life (r = -0.493; p = .022) and reduced preference for employing positive reappraisal when facing a stressor (r = -0.0594; p = 0.0012). Actigraphy confirmed poor sleep quality in a subset of subjects. They had shorter sleep duration (p < .0005), shorter average sleep episodes (p < .005) and more episodes of long awakening (p < 0.05) than community norms. CONCLUSION The results are consistent with the hypotheses that poor sleep may play a unique role in sustaining poor quality of life and impaired coping in patients with schizophrenia. These associations may hold for community controls as well.
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Affiliation(s)
- John R Hofstetter
- Department of Psychiatry, R.L. Roudebush VA Medical Center, 1481 W. 10St, Indianapolis, IN, 46202, USA and Department of Psychiatry, Indiana University School of Medicine, 1111 W. 10St, Indianapolis, IN, 46202, USA
| | - Paul H Lysaker
- Department of Psychiatry, R.L. Roudebush VA Medical Center, 1481 W. 10St, Indianapolis, IN, 46202, USA and Department of Psychiatry, Indiana University School of Medicine, 1111 W. 10St, Indianapolis, IN, 46202, USA
| | - Aimee R Mayeda
- Department of Psychiatry, R.L. Roudebush VA Medical Center, 1481 W. 10St, Indianapolis, IN, 46202, USA and Department of Psychiatry, Indiana University School of Medicine, 1111 W. 10St, Indianapolis, IN, 46202, USA
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Gleeson JF, Rawlings D, Jackson HJ, McGorry PD. Agreeableness and neuroticism as predictors of relapse after first-episode psychosis: a prospective follow-up study. J Nerv Ment Dis 2005; 193:160-9. [PMID: 15729105 DOI: 10.1097/01.nmd.0000154841.99550.d3] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Cross-sectional investigations, using the five-factor model of personality have evinced relationships among neuroticism, agreeableness, and psychotic symptoms. The current study examined these relationships via a prospective follow-up study with remitted first-episode psychosis patients. Baseline five-factor model personality profiles, diagnoses, symptom ratings, and premorbid adjustment ratings were followed by nine monthly ratings on Brief Psychiatric Rating Scale psychosis items in 60 first-episode patients. Valid baseline personality profiles were completed by 40 patients. Patients who had a return of symptoms scored higher on baseline neuroticism and agreeableness than those who remained in remission. Premorbid adjustment also predicted return of symptoms. After premorbid adjustment was controlled for, the agreeableness differences remained significant, but the neuroticism scores were no longer significantly different. It is concluded that lower agreeableness acts as a mediating variable in relapse. Further studies should clarify whether agreeableness is associated with specific biases in processing interpersonal information, and interpersonal behaviors.
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Affiliation(s)
- John F Gleeson
- Department of Psychology, University of Melbourne, Melbourne, Victoria, Australia
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Lysaker PH, Davis LW. Social function in schizophrenia and schizoaffective disorder: associations with personality, symptoms and neurocognition. Health Qual Life Outcomes 2004; 2:15. [PMID: 15025789 PMCID: PMC398420 DOI: 10.1186/1477-7525-2-15] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2003] [Accepted: 03/16/2004] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Research has indicated that stable individual differences in personality exist among persons with schizophrenia spectrum disorders predating illness onset that are linked to symptoms and self appraised quality of life. Less is known about how closely individual differences in personality are uniquely related to levels of social relationships, a domain of dysfunction in schizophrenia more often linked in the literature with symptoms and neurocognitive deficits. This study tested the hypothesis that trait levels of personality as defined using the five-factor model of personality would be linked to social function in schizophrenia. METHODS A self-report measure of the five factor model of personality was gathered along with ratings of social function, symptoms and assessments of neurocognition for 65 participants with schizophrenia or schizoaffective disorder. RESULTS Univariate correlations and stepwise multiple regression indicated that frequency of social interaction was predicted by higher levels of the trait of Agreeableness, fewer negative symptoms, better verbal memory and at the trend level, lesser Neuroticism (R2 =.42, p <.0001). In contrast, capacity for intimacy was predicted by fewer negative symptoms, higher levels of Agreeableness, Openness, and Conscientiousness and at the trend level, fewer positive symptoms (R2 =.67, p <.0001). CONCLUSIONS Taken together, the findings of this study suggest that person-centered variables such as personality, may account for some of the broad differences seen in outcome in schizophrenia spectrum disorders, including social outcomes. One interpretation of the results of this study is that differences in personality combine with symptoms and neurocognitive deficits to affect how persons with schizophrenia are able to form and sustain social connections with others.
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Affiliation(s)
- Paul H Lysaker
- Roudebush VA Medical Center, Day Hospital 116H, 1481 West 10th St, Indianapolis, Indiana 46202, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
| | - Louanne W Davis
- Roudebush VA Medical Center, Day Hospital 116H, 1481 West 10th St, Indianapolis, Indiana 46202, USA
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