Personality traits and self‐injurious behaviour in patients with eating disorders

The interest in different aspects of personality and the neuropsychological basis for behaviour in eating disorder patients has increased over the last decade. The present study aims at exploring personality traits, self‐injurious behaviour (SIB) and suicide attempts in a group of severely ill eating disorder patients. Patients with eating disorders (N = 38) and age‐matched controls (N = 67) were examined concerning self‐reported personality traits by means of the Karolinska scales of personality (KSP). Psychosocial history and SIB was collected from medical records. Depression was rated by means of the Beck Depression Inventory (BDI). Results indicated significantly higher anxiety‐related and detachment traits in both anorexia nervosa (AN) and bulimia nervosa (BN) patients and higher hostility in BN patients than controls. No specific personality traits could be defined as typical for self‐injurious or suicidal behaviour. The AN group was lower than the BN group on scales measuring impulsivity, guilt and anxiety. Furthermore, presence of SIB and suicide attempts was more frequent among the BN patients. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association.     

Association of personality with the development and persistence of obesity: a meta‐analysis based on individual–participant data

Personality is thought to affect obesity risk but before such information can be incorporated into prevention and intervention plans, robust and converging evidence concerning the most relevant personality traits is needed. We performed a meta‐analysis based on individual–participant data from nine cohort studies to examine whether broad‐level personality traits predict the development and persistence of obesity (n = 78,931 men and women; mean age 50 years). Personality was assessed using inventories of the Five‐Factor Model (extraversion, neuroticism, agreeableness, conscientiousness and openness to experience). High conscientiousness – reflecting high self‐control, orderliness and adherence to social norms – was associated with lower obesity risk across studies (pooled odds ratio [OR] = 0.84; 95% confidence interval [CI] = 0.80–0.88 per 1 standard deviation increment in conscientiousness). Over a mean follow‐up of 5.4 years, conscientiousness predicted lower obesity risk in initially non‐obese individuals (OR = 0.88, 95% CI = 0.85–0.92; n = 33,981) and was associated with greater likelihood of reversion to non‐obese among initially obese individuals (OR = 1.08, 95% CI = 1.01–1.14; n = 9,657). Other personality traits were not associated with obesity in the pooled analysis, and there was substantial heterogeneity in the associations between studies. The findings indicate that conscientiousness may be the only broad‐level personality trait of the Five‐Factor Model that is consistently associated with obesity across populations.     

Day treatment group programme for eating disorders: reasons for drop‐out

This study was designed to identify clinical variables and personality factors that could predict the completion or non‐completion of a day treatment group programme for patients with eating disorders. Patients (n = 125) were subdivided into those who had completed a 4‐month day treatment programme (n = 106) and those who had dropped out (n = 19). All the patients had been assessed with regard to eating psychopathology, general psychopathology and personality features at the beginning of the programme. At presentation, 50.4 per cent fulfilled DSM‐IV criteria for anorexia nervosa, 39.2 per cent for bulimia nervosa and 10.4 per cent for an eating disorder not otherwise specified. Non‐completion of therapy was associated with more severe bulimic symptoms, high levels of aggression and extraversion and low levels of inhibitedness. Assessment of these characteristics could be used to improve the therapy programme and to help those patients at increased risk of dropping out. Copyright © 2004 John Wiley & Sons, Ltd and Eating Disorders Association.     

The Role of Non‐suicidal Self‐Injury and Binge‐Eating/Purging Behaviours in the Caregiving Experience Among Mothers and Fathers of Adolescents with Eating Disorders

This study investigated the caregiving experiences of mothers and fathers of restrictive and binge‐eating/purging eating disordered (ED) inpatients with and without non‐suicidal self‐injury (NSSI). Sixty‐five mothers and 65 fathers completed the Experience of Caregiving Inventory. All inpatients completed the Self‐Injury Questionnaire—Treatment Related to assess NSSI and the Eating Disorder Evaluation Scale to assess eating disorder symptoms. Mothers reported significant more negative and more positive caregiving experiences compared with fathers. Mothers (but not fathers) of restrictive ED patients reported more positive caregiving experiences compared with mothers of binge‐eating/purging patients. The presence of NSSI in ED patients was associated with more negative caregiving experiences of both parents. Mothers and fathers of ED inpatients differ in caregiving experiences, and both binge‐eating behaviours and NSSI negatively affect their caregiving experience. Therefore, supportive interventions for parents of ED patients are necessary, especially of those patients who engage in NSSI. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.     

Patient–provider perceptions of diabetes and its impact on self‐management: a comparison of African‐American and White patients

Aims To compare patient–provider differences in diabetes‐related perceptions between African‐American and White patients and to examine its association with self‐care behaviours. Methods One hundred and thirty patient–provider pairs were recruited from the greater Detroit area. Patients and providers completed a survey assessing perceptions about diabetes‐related concepts and demographic background. The Diabetes Semantic Differential Scale was used to measure diabetes‐related perceptions. Patients also reported the frequency of performing self‐care behaviours, including following a healthy eating plan, engaging in physical activity, blood glucose monitoring, and taking medication and/or insulin. Results There were a greater number of patient–provider differences in diabetes‐related perceptions for the African‐American patients (nine of 18 concepts) compared with the White patients (four of 18 concepts). Stepwise regression analyses found patients’ semantic differential scores to be significantly associated with five self‐care behaviours for African‐American patients and two self‐care behaviours for White patients. Providers’ semantic differential scores emerged as predictors of self‐care behaviours for African‐American patients, but not for White patients. Conclusions Our findings suggest that compared with White patients, African‐Americans differ in a greater number of diabetes‐related perceptions than their providers. Patients’ and providers’ perceptions of diabetes care concepts have a significant impact on a greater number of self‐care behaviours for African‐American patients than White patients.     

Pre‐morbid psychiatric morbidity,comorbidity and personality in patients with anorexia nervosa compared to their healthy sisters

Anorexia nervosa (AN) has been linked with pre‐morbid disorders, comorbidity, and specific personality traits in between‐family case–control studies. However, these findings have not been replicated in within‐family studies, and it is not known whether these factors are linked specifically with AN or are shared familial factors. We aimed to compare pre‐morbid disorders, comorbidity, and specific personality traits between sister‐pairs discordant for AN. Forty‐five families with two sisters discordant for AN were retrospectively assessed by interview and questionnaires. The proband with AN had mood disorders and personality disorders (PDs) more frequently than their sister and had lower scores of novelty seeking, self‐directedness and cooperativeness, and higher scores of harm avoidance, persistence, self‐transcendence and of all EDI‐2 scales. In conclusion, major depression, cluster C PDs, persistence, harm avoidance, and self‐transcendence appear to be specifically linked to AN and to be individual‐specific in nature. Major depression seems to be a risk factor for AN. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association.     

Personality disorders in patients in a day‐treatment programme for eating disorders

The present study examined the prevalence of DSM‐III‐R personality disorders (PDs) and levels of depressive symptoms in patients in a day‐hospital programme for eating disorders. Sixty‐five patients diagnosed with anorexia nervosa and bulimia nervosa were administered the Personality Diagnostic Questionnaire Revised (PDQ‐R), the Eating Disorder Inventory (EDI) and the Beck Depression Inventory (BDI). In total, 49.2 per cent of all patients had at least one PD diagnosis. No significant difference was found between patients with bulimia nervosa and anorexia nervosa. Eating Disorder patients with at least one PD had higher scores on the BDI and three EDI subscales compared to patients without a PD. In general, the prevalence of Personality Disorders in the present sample tended to be closer to results quoted by studies with eating‐disordered outpatients rather than inpatients. Axis I disorders may affect personality state measures. Copyright © 2000 John Wiley & Sons, Ltd and Eating Disorders Association.     

Do personality characteristics predict longevity? Findings from the Tokyo Centenarian Study

To explore whether personality influences longevity we examined the personality characteristics of centenarians. We developed a new method that compares an actual personality test score for centenarians with a predicted test score for a 100-year-old, calculated from younger controls. The participants consisted of 70 cognitively intact Japanese centenarians aged 100–106 years and 1812 elderly people aged 60–84 years, all residents of Tokyo. The NEO five factor inventory (NEO-FFI) was used to assess the “big five” personality traits: neuroticism, extraversion, openness, agreeableness, and conscientiousness. The results showed higher openness in both male and female centenarians, and higher conscientiousness and extraversion in female centenarians, as compared to controls. These results suggest that high scores in the specific personality traits conscientiousness, extraversion, and openness, are associated with longevity. We speculate that these personality traits contribute to longevity through health-related behavior, stress reduction, and adaptation to the challenging problems of the “oldest old”.     

Self‐liking and self‐competence: relationship to symptoms of anorexia nervosa

Self‐esteem has been hypothesised to play a pivotal role in the development and treatment, and outcome of anorexia nervosa (AN). Though this relationship is typically investigated by considering self‐esteem as a unitary construct, research suggests that this comprises of two related but distinct components of self‐liking and self‐competence. This study investigates the association between self‐liking, self‐competence, and symptomatology of AN through the course of a defined treatment episode in 77 women. Self‐liking was significantly associated with laxative abuse. Self‐competence was significantly associated with elevated ineffectiveness, perfectionism and interpersonal distrust. Although self‐competence and eating disturbance severity significantly improved over the treatment episode, one in three participants reported a reduced self‐like or self‐competence. Changes in both self‐competence and self‐liking at the end of treatment was associated with changes in drive for thinness. Such findings have implications for treatment models concerned with improving self‐esteem. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association.     

大五人格与支气管哮喘伴发抑郁的关系研究

目的 研究大五人格与支气管哮喘(简称哮喘)伴发抑郁的关系.方法 对216例哮喘患者应用大五人格量表和自评抑郁量表进行调查,对收集到的数据运用SPSS 11.5进行t检验、Pearson相关分析和多元逐步回归分析.结果 抑郁组与非抑郁哮喘患者在人格的神经质、外向性、开放性、愉悦性和公正严谨性维度上均存在显著性差异.哮喘伴发抑郁与患者人格的神经质维度呈显著正相关,与外向性、公正严谨性维度呈显著负相关.大五人格中的抑郁、严谨、积极情绪、活跃、自我意识是预测哮喘伴发抑郁的人格特质.结论 抑郁组与非抑郁组哮喘患者在人格上存在显著差异,大五人格中的抑郁、严谨、积极情绪、活跃、自我意识是预测哮喘伴发抑郁的人格特质.     

French adaptation of the eating disorder recovery self‐efficacy questionnaire (EDRSQ): Psychometric properties and conceptual overview

High prevalence of Eating Disorders (EDs) and poor treatment outcome rates have urged research in the assessment of EDs. Self‐efficacy is a key motivational factor in the recovery from EDs. A self‐report measure, the Eating Disorder Recovery Self‐Efficacy Questionnaire (EDRSQ), was recently developed to assess confidence in adopting healthy eating behaviours and in maintaining a realistic body image. The objectives of this study were to (a) translate the EDRSQ to French (EDRSQ‐F), (b) assess the psychometric properties of this French version, and (c) establish normative data for a non‐clinical sample. Participants were 203 undergraduate women. They completed the EDRSQ‐F and measures of ED symptoms, depression and self‐esteem. A confirmatory factor analysis (CFA) revealed a bi‐factorial structure. Both scales demonstrated evidence of reliability and theoretically consistent evidence of construct validity. Findings support the validity of the EDRSQ‐F and suggest it is a useful instrument for the assessment of EDs. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.     

Relationships Between Self‐Reported and Observed Parenting Behaviour,Adolescent Disordered Eating Attitudes and Behaviours,and the 5‐HTTLPR Polymorphism: Data From the Australian Temperament Project

This study examined whether self‐reported and observationally measured parental behaviours were associated with disordered eating, and investigated possible moderation by a serotonin‐transporter polymorphism (5‐HTTLPR). Study 1 included 650 adolescents from the Australian Temperament Project who completed the Eating Disorder Inventory‐2 Drive for Thinness and Bulimia scales at 15/16 years and were genotyped for 5‐HTTLPR. Parents completed an Australian Temperament Project‐devised measure of parental warmth and harsh punishment. Study 2 included a subgroup of 304 participants who also engaged in a video‐recorded family interaction, with observed parental warmth and hostility coded by the Iowa Family Interaction Rating Scale. Greater self‐reported parental warmth was associated with lower bulimia scores. Conversely, observationally measured parental warmth was associated with lower drive for thinness, but not bulimia. Self‐reported parental harsh punishment was associated with bulimia only, with observed parental hostility associated with neither outcome. 5‐HTTLPR genotype did not moderate the relationship between parent behaviours and adolescent disordered eating. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.     

低收入女性性服务人员人格特征及行为相关性研究

目的探讨女性性服务人员(FSWs)的人格特征及其对行为的影响。方法用五项人格问卷修订版(NEO-PI-R)对227名FSW进行测试,选择236名宾馆女性服务人员作为对照;同时对FSW开展行为调查。结果 FSW在外向性、开放性、顺同性和谨慎性维度及相应特质的得分,明显低于对照组,而在神经质维度及相应特质的得分明显高于对照组。FSW中艾滋病知识得分与开放性维度、顺同性维度有统计学意义,安全套使用频率与神经质维度、外向性维度的得分有统计学意义。结论 FSW的个性特征与普通女性服务人员有明显的差异,而且人格特征与行为具有相关性。     

冠心病伴发的抑郁与人格、应对方式和社会支持的关系

目的：研究冠心病伴发的抑郁情绪与人格、应对方式和社会支持的关系。方法：对240例住院冠心病患者应用自评抑郁量表、简式大五人格量表、特质应对方式问卷和领悟社会支持量表进行调查,对收集到的数据进行相关分析和多元逐步回归分析。结果：抑郁组（90例）与非抑郁组（150例）冠心病患者在人格的外向性、神经质、严谨性、开放性以及社会支持总分和家庭外支持上均存在显著性差异（P〈0．05～〈0．01）;冠心病伴发的抑郁情绪与患者人格的外向性、开放性、神经质、严谨性,应对方式与社会支持显著相关（r=-0．293～0．582,P〈0．01）;人格的神经质、社会支持总分、积极应对和公正严谨性进人抑郁的回归方程（β=-0．18～0．30,P〈0．05～〈0．01）。结论：人格的神经质、社会支持、积极应对和公正严谨性是影响冠心病伴发抑郁情绪的关键因素。     

Pre‐attentive exposure to the thin female beauty ideal does not affect women's mood,self‐esteem and eating behaviour

Exposure to the thin beauty ideal has been found to decrease women's mood and self‐esteem as well as to increase self‐reported eating pathology. In the present study, it was tested whether the changes in mood, self‐esteem and eating behaviour could be activated outside of conscious attention by ultrashort exposure to either slides of thin media models, obese models or neutral slides. The subliminal exposure did not affect women's mood and self‐esteem in the expected way and the eating behaviour of restrained and unrestrained subjects was unaffected by the manipulation. It is concluded that pre‐attentive exposure to the thin beauty ideal had no devastating effect on the well‐being of women. Note that data from supraliminal studies may be seriously confounded by demand characteristics like answering in a socially desirable way. Copyright © 2001 John Wiley & Sons, Ltd and Eating Disorders Association.     

The Role of Non‐Suicidal Self‐Injury and Binge‐Eating/Purging Behaviours in Family Functioning in Eating Disorders

This study aimed to investigate family functioning of restrictive and binge‐eating/purging eating disordered adolescents with or without non‐suicidal self‐injury (NSSI), as perceived by the patients and their parents (mothers and fathers). In total, 123 patients (between 14 and 24 years), 98 mothers and 79 fathers completed the Family Assessment Device. Patients completed the Self‐Injury Questionnaire‐Treatment Related and the Symptom Checklist 90‐Revised. No main effects were found of restrictive versus binge‐eating/purging behaviour nor of presence/absence of NSSI. For the parents, a significant interaction between binge‐eating/purging behaviour and NSSI emerged: Mothers and fathers reported worse family functioning in the binge‐eating/purging group in presence of NSSI, whereas mothers reported worse family functioning in the restrictive group without NSSI. Parental perception of family functioning is affected by the combined presence of binge‐eating/purging behaviour and NSSI. This finding should be taken into account when treating families living with eating disorders. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.     

Personal standards,self‐evaluation and perceived benefits of thinness in girls and young women with disturbed eating

The aim of this study was to examine personal standards, self‐evaluation and perceived benefits of thinness in Swedish females 14–21 years with disturbed eating (DE) and to compare these to a group with other psychosocial problems and to a symptom free group. Seventy subjects with DE‐group, 65 subjects with psychosocial problems and 70 symptom free subjects were compared regarding items selected from four questionnaires. High personal standards expressed in a competitive way were specific for the DE‐group. In comparison with the other groups the DE‐group also reported significantly more perceived benefits of thinness and they more frequently believed that thinness would make them more popular. The DE‐group also reported a more negative self‐evaluation, although this was a trait shared with the subjects with other psychosocial problems and consequently not specific for the DE‐group. Identifying specific factors that perpetuate DE habits is important in order to improve our understanding and enhance the treatment of eating disorders. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association.     

Home self‐dilatation for esophageal strictures

Esophageal strictures secondary to caustic ingestion, head and neck radiation and at the anastomosis post‐esophagectomy tend to be refractory to one or several dilatations. One option for these strictures is home self‐dilatation. The aim of this study was to assess the efficacy and safety of home self‐dilatation for a refractory esophageal stricture. A retrospective chart review was performed of all patients from 1997 to 2009 that performed home self‐dilatation for an esophageal stricture. Patients with proximal strictures without tortuosity or a shelf proximal to the stricture were selected for self‐dilatation. The patients were taught self‐dilatation by the surgeon and an experienced nurse, and an appropriate sized Maloney dilator was provided to the patient and returned when no longer needed. There were 16 patients (11 male and 5 female) with a median age of 60 years (range 38–78). The stricture was related to the anastomosis after esophagectomy in 12 patients, caustic injury in 3 patients and cervical chemoradiotherapy in 1 patient. Prior to initiation of self‐dilatation patients had a median of four endoscopic dilatations. Self‐dilatation was done with a Maloney dilator ranging in size from 45 to 60 French. The median duration of self‐dilatation was 16 weeks. No patient had a perforation or complication related to self‐dilatation. No patient required stenting or repetitive endoscopic dilatations because of failure of self‐dilatation. Strictures recurred in two patients after cessation of self‐dilatation and both responded to endoscopic dilatation followed by additional self‐dilatation. Self‐dilatation effectively resolves refractory esophageal strictures. It was well tolerated, and there were no complications in this series. Home self‐dilatation should be considered the treatment of choice in appropriate patients with refractory esophageal strictures in the cervical esophagus.     

Personality Traits of Centenarians' Offspring

OBJECTIVES: To determine whether the offspring of centenarians have personality characteristics that are distinct from the general population.
DESIGN: Case-control.
SETTING: Nationwide U.S. sample.
PARTICIPANTS: Unrelated offspring of centenarians (n=246, mean age 75) were compared with published norms.
MEASUREMENTS: Using the NEO-Five-Factor Inventory (NEO-FFI) questionnaire, measures of the personality traits neuroticism, extraversion, openness, agreeableness, and conscientiousness were obtained. T-scores and percentiles were calculated according to sex and used to interpret the results.
RESULTS: Male and female offspring of centenarians scored in the low range of published norms for neuroticism and in the high range for extraversion. The women also scored comparatively high in agreeableness. Otherwise, both sexes scored within normal range for conscientiousness and openness, and the men scored within normal range for agreeableness.
CONCLUSION: Specific personality traits may be important to the relative successful aging demonstrated by the offspring of centenarians. Similarities across four of the five domains between male and female offspring is noteworthy and may relate to their successful aging. Measures of personality are an important phenotype to include in studies that assess genetic and environmental influences of longevity and successful aging.     

Personality Subtypes in Female Pre‐Bariatric Obese Patients: Do They Differ in Eating Disorder Symptoms,Psychological Complaints and Coping Behaviour?

In the pre‐bariatric psychological assessment of 102 morbidly obese women, two personality subtypes emerged: a resilient/high functioning subtype with a ‘normal’ personality profile and an emotional dysregulated/undercontrolled subtype, characterized by high neuroticism and low extraversion/conscientiousness. Emotional dysregulated/undercontrolled patients showed more concerns about eating/weight/shape, more binge eating driven by emotions and external triggers, more psychological complaints (such as depression and anxiety) and more avoidance and depressive coping reactions than resilient/high functioning patients. Further research should clarify whether these clearly different psychological profiles are related to different outcomes (weight loss or well‐being) of bariatric surgery. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.