Applying item response theory to enhance health outcomes assessment

Background Health-related quality of life (HRQL) is an accepted outcome measure in patients with mood and anxiety disorders. Yet, surprisingly little attention has been paid to the determinants. In this paper we test the hypothesis that it is associated with personality traits while controlling for mental disorders. Methods A large sample of outpatients (n=640) with mood and anxiety disorders was studied. The empirically supported five factor model of normal personality traits was assessed using the NEO-FFI and includes: neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness. Mental disorders were assessed with the CIDI, and HRQL with the SF-36. Results Regression analyses revealed that the NEO-FFI scores, with the exception of conscientiousness, were significantly associated with SF-36 subscales and summary scores, independently from the mental disorders. The percentage of explained variance due to the personality traits was highest for the subscales Vitality (10.0%), Mental Health (13.3%) and the Mental Health Summary Score (9.5%). Furthermore, specific personality traits were related to specific SF-36 subscales. Conclusions A low HRQL of patients with mood or anxiety disorders is not only determined by the disease or the current health but is also shaped by personality traits that are relatively stable throughout an individual's life time.     

Antisocial personality disorder, HIV risk behavior and retention in methadone maintenance therapy

In a sample of 55 consecutive methadone maintenance admissions to our clinic, 42% were diagnosed with antisocial personality disorder (ASPD) using the National Institute of Mental Health Diagnostic Interview Schedule NIMH DIS. Individuals with ASPD exhibited greater risk for HIV infection as defined by more sexual contacts, needle use and equipment sharing. Data at 1 year follow-up were obtained on this group of patients. The objective was to compare the ASPD and non-ASPD groups with regards to demographics, drug abuse history, outcome and retention in treatment. There were no significant differences between the groups on any demographic or treatment outcome variables. Survival analysis indicated that there were no group differences in treatment retention. In conclusion, although there were no differences in treatment outcome between ASPD and non-ASPD groups it is possible that ASPD patients who drop out of treatment will be at higher risk for contracting and spreading HIV within the IV drug using population. These data also suggest that in this population the diagnosis of ASPD using primarily behavioral traits as measured in the NIMH-DIS-III, has little utility in predicting treatment outcome.     

288名罪犯中人格问题的初步调查

目的 了解在押罪犯中人格异常的情况以，利于针对性地实施管理和改造。方法 使用“人格诊断问卷”等工具对某监狱在押犯进行调查，并设置对照组进行研究。结果 研究组中的偏执型、分裂型、反社会、边缘型、表演型、自恋型、回避型、被动攻击型和抑郁型人格的分值显著高于对照组。暴力型罪犯的分裂型、反社会型、表演型及被动攻击型人格分值高于财产型罪犯。而财产型罪犯的强迫型分值高于暴力型罪犯。结论 相对于一般的群体而言，由于家庭、成长背景、社会因素的影响，罪犯中的人格偏离较为显著。     

精神分裂症患者心理防御机制与人格特征的相关性分析

目的　探讨精神分裂症患者心理防御方式和人格特片的特点及二者的相关性。方法　分别运用防御方式问卷 (DSQ)和艾森克个性问卷 (EPQ)对 10 1名精神分裂症患者和 30例正常人群进行防御方式评定和人格测定。结果　与正常对照组相比 ,精神分裂症患者更多采用不成熟和中间型防御方式 (P <0 0 5 )。防御方式与人格特征存在着一定的关联性 (P <0 0 5 )。不成熟型防御方式和中间型防御机制与EPQ的精神质 (P)得分和神经质 (N)得分呈显著正相关 (P <0 0 1) ,成熟防御机制与内外向(E)得分呈显著正相关 (P <0 0 5 )。结论　精神分裂症患者更多地使用不成熟防御机制 ,存在病态人格 ,且者之间存在明显相关性 ,有关结果 ,对于探讨精神分裂症患者的病理心理机制和开展心理治疗有指导意义。     

Functional differences among those high and low on a trait measure of psychopathy.

BACKGROUND: It has been established that individuals who score high on measures of psychopathy demonstrate difficulty when performing tasks requiring the interpretation of other's emotional states. The aim of this study was to elucidate the relation of emotion and cognition to individual differences on a standard psychopathy personality inventory (PPI) among a nonpsychiatric population. METHODS: Twenty participants completed the PPI. Following survey completion, a mean split of their scores on the emotional-interpersonal factor was performed, and participants were placed into a high or low group. Functional magnetic resonance imaging data were collected while participants performed a recognition task that required attention be given to either the affect or identity of target stimuli. RESULTS: No significant behavioral differences were found. In response to the affect recognition task, significant differences between high- and low-scoring subjects were observed in several subregions of the frontal cortex, as well as the amygdala. No significant differences were found between the groups in response to the identity recognition condition. CONCLUSIONS: Results indicate that participants scoring high on the PPI, although not behaviorally distinct, demonstrate a significantly different pattern of neural activity (as measured by blood oxygen level-dependent contrast)in response to tasks that require affective processing. The results suggest a unique neural signature associated with personality differences in a nonpsychiatric population.     

强迫症患者的防御机制、父母教养方式及个性特征的调查分析

目的　探讨强迫症患者的防御机制、父母教养方式及其个性特征。方法　采用防御方式问卷 (DSQ)、父母养育方式评价量表 (EMBU)及艾森克个性问卷 (EPQ)对 36例强迫症患者进行了问卷调查 ,并与 36例正常受试者加以比较。结果　①强迫症组中间型和不成熟防御机制因子分均明显高于正常对照组 (P <0 0 1) ,而成熟防御机制因子分则明显低于正常对照组 (P <0 0 5 ) ;②强迫症组父母的情感温暖因子分低 ,而父母的惩罚、拒绝因子分和母亲的偏爱被试因子分高 ,同正常对照组比较 ,差别均具有显著性或非常显著性意义 (P <0 0 1或P <0 0 5 ) ;③强迫症组EPQ的N因子分明显高于正常对照组 ,而E因子分则明显低于正常对照组 (P <0 0 1)。结论　强迫症患者的防御机制、父母教养方式及个性特征与正常人有着明显的不同 ,它为今后开展分析性心理治疗 ,实施心理干预措施提供了依据。     

1341名医学生心理健康水平调查分析

目的 了解医学生心理健康状况,为今后有针对性地在我校开展心理健康教育及心理咨询活动提供参考依据.方法 按分层整群抽样的方法抽取被试,采用大学生人格问卷(UPI)进行比较.结果 57.94%的学生存在不同程度的心理健康问题.男生心理健康状况优于女生,男、女生之间差异有统计学意义(p＜0.01).2004级学生与2005级学生UPI总分比较,两者差异无统计学意义.结论 医学生心理问题不容忽视.应结合医学生的自身特点和性别心理差异,进行不同的心理健康教育.     

甘南州合作地区藏汉学生个性特征及其影响因素的初步探讨

对生长在合作地区的955名藏、汉族学生进行了个性特征及其影响因素的调查探讨。结果表明:本民族间男、女生E分比较,男生低于女生,显示女生性格较男生性格外向倾向性大。稳定性方面女生N分高于男生,即女生情绪一般不及男生稳定。此外与该地区藏汉族学生个性特征关系较为密切的因素是:兄弟姐妹数、父母亲文化程度、职业以及学前教育和智商。     

男性慢性胃炎患者人格特征初探

本文采用卡氏十六种人格因素量表，对纤维胃十二肠镜和活体组织病理检查确诊，剔除可能影响调查的疾患之后的５６例慢性胃炎患者做了测查，结果与中国男性成人常模对照，提示男性慢性胃炎患者的主要人格特征有：严谨、保守、忧郁、紧张、顺从、依赖、有焦虑倾向，非内向个性，不属于心理不健康人群，而与消化性溃疡个性特征有所不同，但是，矫治其人格缺损及属必要。     

优秀运动员人格特征的对照研究

目的探讨优秀运动员人格特征并分析其与心理健康状况的关系．方法采用症状自评量表（SCL-90）和卡氏16项人格因素量表（16PF），封北京市60名不同项目优秀运动员返行心理健康状况测查和人格特点分析，并与60名普通大学生对照。结果（1）卡氏16项人格因素测验，运动员组“乐群”、“恃强”、“敏感”三项得分高于大学生组（P〈0．05）；“独立”因于分低于大学生组（P〈0．05）。（2）SCL-90自评量表得分除了“恐怖”一项外，优秀运动员组得分均高于大学生组，其中“躯体化”和“敌对”两项得分显着高于大学生组（P〈0．05）。（3）卡氏16项人格因素测验中，“敢为”一项优秀运动贝组内的健将组得分高于一级运动员组（P〈0．05）。（4）SCL-90自抨量表测试结果，除“躯体化”一项因子分，其它各项得分优秀运动贝组内健将运动员均低于一般运动贝。其中“强迫症状”、“人际关系敏感”、“抑郁”和“偏执”四个因子分健将组与一级运动员组之间均有显着性差异（P〈0．05）。结论我国优秀运动贝人格特征趋于外向，好强执着，但“自立”因子分却低于普通大学生组。“敢为”因子分在优秀运动贝组内，健将组得分高于一级运动员组，说明在一定程度上“敢为”因子与运动成绩相关。