The role of memory in personality continuity: a 25 year follow-up

Several longitudinal studies have been published showing high retest coefficients in self-report personality inventories. While the data suggest stability in personality over long periods of adulthood, critics have argued that individuals may be motivated to present themselves in consistent fashion to the investigator. It has been suggested that respondents may remember how they answered the items previously. Thus, memory and the desire for consistency may be responsible for the high stability coefficients typically observed. In the present study 85 individuals who had completed the California Test of Personality as university students in 1944 were asked to complete it again 25 years later. Respondents were instructed to remember how they had answered the inventory as students and to fill it out in that manner (Retrospective condition) in addition to responding as they were in the present (Self condition). Results indicated high retest correlations between the 1944 and 1969 Self conditions, whereas the correlations between the 1944 Self and 1969 Retrospective conditions were much lower. Subjects describing their present selves obtained scores more highly correlated with their 1944 scores than scores created by attempting to describe themselves as they had been 25 years previously. These data indicate that memory for responses to a personality inventory taken years before is inaccurate, and that it cannot account for the observed consistency in personality test scores.     

Personality in advanced old age: continuity or change?

A longitudinal study of elderly persons found evidence of personality development even in advanced old age. Five traits, similar to traits found in younger persons, were identified. Although considerable continuity was found, change also was apparent. An increase in agreeableness was observed for the old-old, bringing their scores up to the level maintained by the oldest-old. Two traits were stable: satisfaction (65% did not change reliably) and intellect (63% did not change reliably). A decline in extraversion occurred in both age groups. Energetic, in which 40% declined, may be more affected than the other traits by external, environmental circumstances. The study confirms the findings of longitudinal studies of children and younger adults and extends them into the final stages of life.     

社会心理因素与室性心律失常相关性研究

对５０例临床上没有心脏器质性损害证据的室性心律失常（ＶＡ）患者和５０例正常人进行对照研究。结果表明：病例组所经历的生活事件频数、负性生活事件紧张值、Ａ型行为评分、消极应付方式均明显高于对照组（Ｐ＜０．００１）。社会支持总分和积极应付方式均显著低于对照组。多元线性回归发现ＶＡ的主要社会心理危险因素为：神经质、焦虑、敌对和负性生活事件，而社会支持和阳性生活事件为保护因素。这些均提示ＶＡ的发生发展是多因素共同致病的结果，其中社会心理环境起着极为重要的作用。     

Psychological and Demographic Correlates of Glycaemic Control in Adult Patients with Type 1 Diabetes

The relationship between an objective measure of glycaemic control (glycated haemoglobin (HbA₁)) and personality variables was examined in two separate groups of adult Type 1 (insulin-dependent) diabetic patients. Study 1 included 121 patients, all of whom also had subjective self-reporting of treatment compliance assessed, while the first 57 patients had individual differences in intelligence, major dimensions of personality and forgetfulness documented. Study 2 examined 303 patients, all of whom had their major dimensions of personality assessed using a shortened and updated version of the original personality questionnaire. Demographic indices (age, onset-age, duration of diabetes) were assessed in both groups. No significant correlation was found between HbA₁ and self-report compliance suggesting that self-reporting may be invalid as a measure of glycaemic control. In study 1 personality and intelligence variables did not correlate significantly with HbA₁ values. Older patients with shorter duration of diabetes had significantly better glycaemic control (p<0.05). A significant correlation was observed between HbA₁ concentration and onset-age of diabetes (p<0.001); the patients who had developed diabetes later in life were achieving better control of their blood glucose. In the larger number of subjects in study 2 no significant correlations were evident between HbA₁ and personality variables. It is concluded that the predictors of glycaemic control indexed by HbA₁ may be distinct from predictors of self-report compliance and that the latter have limited or no value in providing an assessment of quality of glycaemic control. There is no evidence of an effect of personality on glycaemic control as measured by HbA₁.     

Personality,wellbeing, and quality of life in patients with tooth wear

BackgroundThe aim of this study was to investigate, in a cohort of patients with pathological levels of tooth wear, the effect of personality and general psychological wellbeing on generic and condition specific (CS) quality of life.MethodsPatients with pathological levels of tooth wear aged 18–70 years referred to the Eastman Dental Hospital for advice on the management of their tooth wear were invited to participate. Participants completed a CS oral impact on daily performances (OIDP) quality of life questionnaire, a NEO five-factor inventory personality questionnaire, and the general health questionnaire-12 (GHQ). Tooth wear severity was measured using the basic erosive wear examination (BEWE).Findings102 individuals were recruited. Increased BEWE scores were positively correlated with increasing age (p=0·046) and decreased generic and CS quality of life (p=0·017 and 0·031, respectively). Increased neuroticism values were positively correlated with increased generic OIDP score (p=0·007), CS OIDP score (p=0·003), generic and CS eating scores (p=0·025 and p=0·035, respectively), CS smiling score (p=0·029), and CS carrying out major work score (p=0·039). Increased general psychological wellbeing scores were positively correlated with increased generic and CS OIDP scores (p=0·009), generic and CS eating scores (p=0·009 and p=0·003, respectively), CS speaking scores (p=0·018), generic and CS cleaning scores (p=0·002 and p=0·004, respectively), generic relaxing scores (p=0·003), generic and CS smiling scores (p<0·0001 and p<0·0001, respectively), and generic emotional state score (p=0·015). Multivariate linear regression analyses revealed that increased levels of neuroticism and decreased levels of general psychological wellbeing both had an independent and significant effect on generic and CS OIDP scores when adjusted for tooth wear severity (p<0·05).InterpretationIn this cohort of patients with pathological tooth wear, higher levels of neuroticism and decreased levels of general psychological wellbeing had a significant negative effect on quality of life. For patients with tooth wear, treating their condition solely may not help to improve quality of life because other factors may affect their perception.FundingUniversity College London and National Institute for Health Research.     

Constructive thinking, rational intelligence and irritable bowel syndrome

AIM： To evaluate rational and experiential intelligence in irritable bowel syndrome （IBS） sufferers. METHODS： We recruited 100 subjects with IBS as per Rome 11 criteria （50 consulters and 50 non-consulters） and 100 healthy controls, matched by age, sex and educational level. Cases and controls completed a clinical questionnaire （including symptom characteristics and medical consultation） and the following tests： rational- intelligence （Wechsler Adult Intelligence Scale, 3rd edition）; experiential-intelligence （Constructive Thinking Inventory）; personality （NEO personality inventory）; psychopathology （MMPI-2）, anxiety （state-trait anxiety inventory） and life events （social readjustment rating scale）. Analysis of variance was used to compare the test results of IBS-sufferers and controls, and a logistic regression model was then constructed and adjusted for age, sex and educational level to evaluate any possible association with IBS. RESULTS： No differences were found between IBS cases and controls in terms of IQ （102.0 ± 10.8 vs 102.8 ± 12.6）, but IBS sufferers scored significantly lower in global constructive thinking （43.7± 9.4 vs 49.6 ± 9.7）. In the logistic regression model, global constructive thinking score was independently linked to suffering from IBS [OR 0.92 （0.87-0.97）], without significant OR for total IQ. CONCLUSION： IBS subjects do not show lower rational intelligence than controls, but lower experiential intelligence is nevertheless associated with IBS.     

Providing disease-related information worsens health-related quality of life in inflammatory bowel disease

BACKGROUND: Patients with inflammatory bowel disease (IBD) have identified a need for more information about their disease. PURPOSE: To assess the effect of an educational intervention on health-related quality of life (HRQOL) in patients with IBD. METHODS: Consecutive ambulatory IBD patients were randomized to receive four IBD-specific educational booklets or usual care. Subjects completed two disease-specific HRQOL questionnaires-the Inflammatory Bowel Disease Questionnaire (IBDQ) (range 1-poor to 7-excellent) and the Quality Index in Crohn's and Colitis (QuICC) (range 1-excellent to 5-poor) at entry and after 2 weeks. The mean change in HRQOL scores at follow-up was compared between the education and control groups. RESULTS: 59 subjects participated, with a mean age of 40.0 +/- 11.9 years. 34 were given educational booklets and 25 received standard care. 6 patients (10%) did not complete the study. Mean IBDQ scores became significantly worse in the education group with a change of -0.17 +/- 0.49 compared with controls at +0.28 +/- 0.62 (p = 0.006). This could be explained by worsened disease activity in the education group. There was no significant change in the QuICC scores (p = 0.61). Education group patients who had not received prior educational material had improved mean IBDQ scores of +0.24 +/- 0.47 compared with education patients who had received educational material prior to this study, with a score change of -0.25 +/- 0.46 (p = 0.09). CONCLUSIONS: The addition of educational booklets to IBD patients in a tertiary center does not improve, and may worsen, short-term HRQOL. Education of newly diagnosed or less informed patients should be studied further.     

北京城区老年人心理健康状况及其相关因素分析

目的　调查北京城区老年人心理健康状况 ,分析其主要相关因素 ,并提出相应的改善措施。方法　对象为北京城区老年人 1 0 1 0例。采用自编老年心理健康问卷作为评定工具。结果　老年人心理健康总分存在显著的性别、教育水平和职业差异 ,年龄和婚姻差异不显著 ;健康满意度、生活满意度、经济满意度、夫妻关系满意度、亲子关系满意度、患病数、重大生活事件数与心理健康总分或分量表分相关显著 ;回归分析发现 ,健康满意度和教育水平对总分有显著影响。结论　北京城区老年人心理健康保持尚好 ,促进老年人身体健康和提高其教育水平将有助于改善其心理健康状况。     

Mortality in alcoholic patients given inpatient treatment

Data on mortality during a 48-month follow-up period in a group of 1410 alcoholics who had received inpatient treatment were evaluated. In 1266 patients known to be either living or deceased the death rate was 7.6%. The percentage of deceased subjects was highest in the group over SO years of age. The mortality rate was higher for men (9.8%) than for women (4.8%); for those with more than one divorce (16.8%); for those who were not fit for work (18.1%) of were retired at the start of the treatment (43.3%); who were employed in the alcohol business (21. 7%); who had reduced their alcohol consumption before treatment (13.4%); who were unemployed 6 months after discharge (12.4%). The mortality rate was higher for those with high scores on a scale assessing calmness in a personality inventory (7.9%) and low scores on a questionnaire assessing motivation (10.9%) and insight into the need of change (12.4%). Alcohol-related illness before the index treatment played an important role: the mortality rate was higher for those who had had Wemicke-Korsakoff syndrome (40%), delirium tremens (15.3%), pancreatitis (13.9%) or cardiomyopathy (14.1%). The mortality rate was higher for treatment dropouls (12.9%) and for those who regularly or occasionally took sleeping pills (28.5%), psychoactive drugs (15.1%) or other drugs (11.5%) during treatment. In the follow-up periods substance use had a great effect on mortality. The mortality rate or those patients who still abstained from alcohol after 6 months (4.4%) was only a third of that for the patients who had relapsed (12.4%). Patients who took drugs during the 18-month follow-up period also had higher mortality rates: sleeping pills, 9.6%; psychoactive drugs, 9.7%, analgesics 10.7%. Logistic regression identified significant variables at admission: not fit for work, retired, job related to alcohol, suffering from Wernicke-Korsakoff syndrome and no insight for change.     

Modeling intraindividual change in personality traits: findings from the normative aging study

To advance an intraindividual life-span approach to the issue of stability and change, we studied personality trait trajectories in adulthood. Growth curves for extraversion and neuroticism were estimated for over 1600 men (initially aged 43-91) in the Normative Aging Study, who were followed over 12 years. We found significant individual differences in intraindividual change for both traits, as well as different trajectories for extraversion and neuroticism. The overall extraversion trajectory was best defined by a linear model, but neuroticism was characterized by quadratic decline with age. We then considered several variables as predictors of individual differences around these overall trajectories. Birth cohort, marriage or remarriage, death of spouse, and memory complaints were all significant predictors, explaining variability in both level and rate of personality trait change. These findings suggest that there is a good deal of variability in personality trajectories, and that some of this variability can be explained by birth cohort as well as by age-graded life events.     

Psychological responses to thermal stress in a glass bangle factory.

Behavioural studies were conducted on a random sample of 38 glass bangle workers engaged in various occupations and exposed to high ambient temperature (38.2 +/- 3.4 degrees C) and radiant heat (46.2 +/- 5.1 degrees C) during their work in the glass bangle industries at Firozabad, India. Twenty-two control subjects of similar age and socio-economic status unexposed to heat during their work were also studied for comparison. The digit span test, digit symbol test, Bourdon-Wiersma vigilance test, flicker fusion test and Maudsley personality inventory (MPI) were used to assess the behavioural changes induced by the existing heat stress. The mean scores of immediate memory were much lower in the exposed population than in the controls thereby indicating impairment of immediate memory in the study group. The visuo-motor coordination and vigilance were also significantly affected. Visual perception showed a downward trend among the glass bangle workers, although the MPI test indicated no personality changes.     

Personality characteristics and quality of life in patients treated for Cushing's syndrome

OBJECTIVE: Psychological distress does not always disappear upon proper endocrine treatment of Cushing's syndrome, and quality of life may still be compromised. Little is known on the personality correlates that may be involved. The aim of this study was to provide a controlled assessment of personality characteristics and quality of life in patients successfully treated for Cushing's syndrome. DESIGN: A single-centred, controlled, prospective study. PATIENTS: Twenty-four consecutive outpatients who were in remission upon proper treatment of Cushing's syndrome for at least 1 year and no more than 3 years (20 with pituitary-dependent Cushing's disease and four with a cortisol-secreting adrenal adenoma; 5 M/19 F; mean age 34.5, SD = 10.6; range 18-57 years) were compared with 24 healthy control subjects matched for sociodemographic variables. MEASUREMENTS: Both patients and controls were administered two self-rating scales: (a) tridimensional personality questionnaire (TPQ), a 100-item inventory that yields three scales: novelty seeking, harm avoidance and reward dependence. (b) symptom rating test (SRT), a 46-item scale for assessing psychological distress and quality of life with six subscales (anxiety, depression, somatic symptoms, anger-hostility, cognitive symptoms, psychotic symptoms). RESULTS: There were no significant differences in personality dimensions, as measured by the TPQ, between patients and controls. The results did not change when the four patients with an adrenal adenoma were excluded and only the 20 with pituitary-dependent Cushing's disease were considered. As to the SRT scale, patients with Cushing's syndrome displayed significantly higher scores in anxiety (P= 0.046), depression (P= 0.013), and psychotic symptoms (P= 0.006), with a generalized compromised quality of life (P= 0.02). Again, no differences were found in evaluating the 20 patients with Cushing's disease separately. CONCLUSIONS: Even though personality traits other than those explored here may be involved, the results seem to exclude the presence of latent dysfunctional attitudes and beliefs contributing to long-standing psychological disturbances, even in the pituitary-dependent form of Cushing's syndrome. Data from larger populations might provide further insight in this field. The findings of a compromised quality of life are in agreement with the recent literature and have implications for the long-term management of patients.     

Depression in association with severe obesity: changes with weight loss

BACKGROUND: The relationship between depression and severe obesity is unclear. We examined depression before and after surgically induced weight loss. METHODS: Beck Depression Inventory (BDI) questionnaires were completed before and at yearly intervals after gastric-restrictive weight-loss surgery. We used the BDI scores of 487 consecutive patients to identify predictors of depression. Scores from all completed questionnaires were used to follow changes with time. Paired preoperative and 1-year postoperative scores (n = 262) were used to identify predictors of change in BDI score. RESULTS: For the 487 subjects, the mean +/- SD preoperative BDI score was 17.7 +/- 9.5. Higher scores, indicating increased symptoms of depression, were found in younger subjects, women, and those with poorer body image. These factors had independent effects. We found no association between BDI and waist circumference or insulin concentrations. High BDI scores correlated with poorer physical and mental quality-of-life measures. Weight loss was associated with a significant and sustained fall in BDI scores, with a mean +/- SD score of 7.8 +/- 6.5 at 1 year and 9.6 +/- 7.7 at 4 years after surgery. Greater falls in BDI score at 1 year were seen in women, younger subjects, and those with greater excess weight loss (combined r2 = 0.10; P<.001). Fall in BDI score correlated with improvement in appearance evaluation (r = -0.31; P<.001). CONCLUSIONS: Severely obese subjects, especially younger women with poor body image, are at high risk for depression. We found sustained improvement with weight loss. These findings also support the hypothesis that severe obesity causes or aggravates depression.     

Survival in the oldest old: death risk factors in old and very old subjects

Factors predicting death in the ninth decade of life may differ from predictors in younger age groups. A prospective study was carried out on 210 subjects entering a residential home at the age of 68 to 79 years and of 287 subjects aged greater than or equal to 80 years who included 91 survivors from the first group; all subjects were followed until 78% of them had died. A Cox analysis was carried out with death as end point and 13 potential risk factors as covariates. Mildly impaired mobility at entry, defined as the need for help to walk 300-400 yards for various reasons, smoking, bacteriuria, and presence of ECG abnormalities were significant death risk predictors before age 80. Beyond this age, only mildly impaired mobility and serum cholesterol levels less than or equal to 5.9 mmol/L, as compared with levels greater than or equal to 8.0 mmol/L, remained significant. Higher hematocrit levels were predictors of survival before and after age 80. Systolic blood pressure, age, sex, weight, and socioeconomic status had no effect in either group. The data show that survival after age 80 is related only to adequate physical mobility and high hematocrit and cholesterol levels, regardless of the levels of other common risk factors.     

应用临床护理路径对耐多药肺结核患者实施健康教育的效果分析

目的 探讨临床护理路径（简称“临床路径”）应用于耐多药肺结核患者健康教育中的效果。方法 将耐多药肺结核患者分为临床路径组（55例）：男35例,女20例,平均年龄（51±13.8）岁;对照组（50例）：男31例,女19例,平均年龄（52±11.9）岁。临床路径组应用临床路径进行健康教育,对照组采用常规护理方案进行健康教育,比较两组患者健康教育及治疗后生活行为的改变、护理工作满意度和抗结核药物服药依从性。均采用χ²检验,以P<0.05为差异有统计学意义。 结果 两组患者的治疗依从性比较：临床路径组得4分50例,得3分5例,得2分0例,得1分0例;对照组得4分25例,得3分10例,得2分5例,得1分10例。认知行为改变比较：临床路径组基本理解40例,部分理解12例,不能理解3例;对照组基本理解19例,部分理解18例,不能理解13例。护理工作满意度比较：临床路径组满意47例,比较满意5例,基本满意3例,不满意0例;对照组满意30例,比较满意8例,基本满意7例,不满意5例。两者上述3项评价指标经统计学处理,χ²值分别为26.52、8.56、6.95,P值均＜0.01,临床路径组明显高于对照组。 结论 在耐多药肺结核患者健康教育中实施临床路径管理,可有效提高患者对治疗依从性、护理工作满意度和认知行为的改变。     

Internet-based assessment of bowel symptoms and quality of life

OBJECTIVES: We wished to determine the value of an open-access internet questionnaire for assessment of upper and lower gastrointestinal symptoms and health-related quality of life. METHODS: Between January 2002 and June 2005, a symptom scale for upper gastrointestinal and lower gastrointestinal symptoms was placed on a genuine website (www.gesundheits-umfrage.de) and linked to the website of the German irritable bowel syndrome patient group (www.Reizdarmselbsthilfe.de). Patients were asked to report gastrointestinal symptoms that had occurred during the last month. Patients who finished this symptoms questionnaire and acknowledged more than two of a total of eight upper gastrointestinal symptoms and/or more than two of 16 lower gastrointestinal symptoms were immediately offered the assessment of their health-related quality of life by a validated general quality of life scale--the patient general well-being inventory--a 22-item scale with six subscales (anxiety, depression, general well-being, self-control, health, and vitality) and a global scale. Total patient general well-being inventory scores and subscale values were correlated to upper gastrointestinal and lower gastrointestinal symptom scores including the Rome I definition of the irritable bowel syndrome, and to social variables. RESULTS: Five thousand two hundred and fifty-six individuals completed symptom assessment. Out of these, 4431 had three or more upper gastrointestinal symptoms, the mean number of upper gastrointestinal symptoms reported was 3.2+/-2.0; 4456 had three or more lower gastrointestinal symptoms (mean: 10.3+/-3.3), and 3187 met the Rome I criteria for irritable bowel syndrome. A total of 3316 individuals completed the patient general well-being inventory assessment (1156 men, 2160 women, mean age: 37.7+/-12.3 years). Upper gastrointestinal, lower gastrointestinal, and total symptom score were higher in women than in men (P < 0.001), and significantly correlated to the global quality of life assessment. Family status affected the symptom scores (higher in singles) and quality of life scores (lower in people living in partnership for health, but higher for vitality and depression). Age correlated negatively with upper gastrointestinal, lower gastrointestinal, and with total symptom scores as well as with some patient general well-being inventory scores. CONCLUSION: Symptom and quality of life assessment using an open internet questionnaire is feasible and generates data which are, in large, comparable to those from other sources of assessment, despite the fact that the population addressed is, on average, moderately younger than previously studied cohorts.     

Impact of chronic conditions on quality of life in patients with inflammatory bowel disease

BACKGROUND: Although studies suggest that inflammatory bowel disease (IBD) has a significant impact on an individual's health-related quality of life, the added weight of other health conditions and comorbidities has not been investigated. The purpose of this study was to expand on prior research by taking into account the impact of other chronic health conditions on the health-related quality of life of individuals with IBD, and to develop a model to help clinicians understand the relative impact of various predictors of their patients' physical and mental health-related quality of life. METHODS: 615 patients from the gastroenterology outpatient practice of a large, urban university hospital received a self-administered survey including questions about their health conditions, the severity of their bowel symptoms, and their health-related quality of life (measured using the SF-36 instrument). RESULTS: 314 completed surveys were returned, resulting in a response rate of 51.1%. Two regression analyses were conducted to identify the role of patient demographic variables and other chronic conditions on the 2 primary outcomes of interest: the SF-36 Physical Component and Mental Component Summary scores. Statistically significant predictors of physical quality of life included IBD disease severity, arthritis, heart disease, age, anemia, back/shoulder pain, and hypertension; statistically significant predictors of mental health-related quality of life were IBD disease severity, depression/anxiety, age, and headaches. CONCLUSIONS: IBD disease severity is the most important predictor of both physical and mental health-related quality of life in patients with this condition despite the presence of other chronic conditions.     

Effects of exercise training on aerobic capacity and quality of life in individuals with heart failure

PURPOSE: The purpose of this study was to determine whether subjects with chronic heart failure, who completed a 12-week rehabilitation program, would have significantly greater quality of life, better aerobic fitness, less difficulty with symptoms of heart failure, greater self-efficacy for exercise, and higher daily activity levels when compared with subjects in a control group. METHODS: Thirty-one males, aged 64 +/- 10 years with left ventricular ejection fraction of 29 +/- 7%, were randomized to a moderate intensity supervised aerobic exercise program (n = 15) or a control group (n = 16). Twenty-seven subjects completed at least 1 follow-up assessment. RESULTS: After 12 weeks there were significant differences in the change scores for perceived physical function (using RAND Corporation's 36-item short form) (P =.025) and peak oxygen uptake (P =.019) between the exercise and control groups with the exercise group experiencing improved physical function and fitness. CONCLUSIONS: Exercise training in adults with heart failure increases exercise tolerance and perceived physical function. Improved heart failure symptoms, self-efficacy for exercise, or increased physical activity may not be associated with enhancement of exercise tolerance.