The effect of state anxiety on personality measurement

The authors examined the effect of state anxiety on the personality test scores of 56 patients receiving treatment for panic disorder and agoraphobia. The tests were administered before treatment and again 6 weeks later. For the 40 patients who improved by 5 or more points on the Hamilton Anxiety Rating Scale, significant changes in personality measures were observed at week 6, including increased emotional strength and extraversion and decreased interpersonal dependency. The authors conclude that state anxiety, like depression, is a possible confounding factor in personality measurement, and adjustment for it should be made in future studies.     

Symptoms and personality traits of East and West German psychotherapy patients with anxiety and depressive disorders

The aim of this study is to explore symptoms and personality traits of patients from two Psychosomatic University Departments, one in Düsseldorf (West Germany) and the other in Magdeburg (East Germany), suffering from anxiety disorders and depression. 560 unselected outpatients with anxiety disorders and depression were examined with the Symptom-Checklist (SCL-90-R) and the Inventory of Interpersonal Problems (IIP-D). The ratio of these two diagnostic groups in relation to the total number of outpatients in both clinics was analysed. The results show a higher rate of Anxiety disorders in the East German group and a higher rate of depressed patients in the West German group. Both diagnostic groups differ in certain scales of SCL-90-R and IIP-D. These profiles are mainly stable against cultural (East-West) influences. The SCL-90-R and IIP-D should be used to develop diagnostic profiles of the discussed syndromes. Social and cultural influences of patients' self ratings should be taken into account.     

The comorbidity of anxiety disorders with personality,depressive, alcohol and drug disorders

Anxiety disorders seldom exist in isolation from personality traits and disorders, from depressive symptomatology, and from alcohol and drug use and abuse. This review examines the relationships between anxiety disorders and these often comorbid psychiatric disorders. While diagnostic systems such as DSM-III-R which describe multiple, discrete disorders highlight comorbidity and may have value for treatment outcome and other studies, they appear unlikely to generate useful aetiological explanations of the considerable overlap of psychiatric symptomatology seen in anxiety disorder patients.     

人格特质和社会支持对青少年抑郁特质和抑郁状态的影响

目的 探讨人格特质和社会支持对青少年抑郁特质和抑郁状态的独立作用，以及在压力性生活事件对抑郁特质和状态影响中的调节作用。方法 采用方便抽样法，于2022年7—8月选取四川省某所中学的303名中学生为研究对象。采用青少年生活事件量表、中国大五人格问卷简版、青少年社会支持量表、特质抑郁量表、流调用抑郁量表在线调查青少年的压力性生活事件、人格特质、社会支持、抑郁特质、抑郁状态。采用多重线性回归分析人格特质和社会支持对青少年抑郁特质和抑郁状态的影响，并分析人格特质和社会支持在青少年压力性生活事件对抑郁特质和抑郁状态影响中的交互作用。结果 多重线性回归分析结果显示，开放性人格特质与青少年抑郁特质呈负相关（β=-0.17,95%CI:-0.27～-0.08,P<0.05），社会支持与青少年抑郁特质（β=-0.16,95%CI:-0.21～-0.10,P<0.05）和抑郁状态呈负相关（β=-0.13,95%CI:-0.19～-0.07,P<0.05）。交互作用结果显示，开放性人格在生活事件对青少年抑郁特质的影响中表现出调节作用（P<0.05），社会支持在生活事件对青少年抑郁状...     

Relationships between major depressive disorder and comorbid anxiety and personality disorders

OBJECTIVE: The aim of the study was to examine whether comorbid anxiety disorders influence depressed patients' likelihood of meeting criteria for a personality disorder (PD) and whether comorbid anxiety disorders influence the stability of the PDs in patients with remitted depression. METHODS: The initial sample consisted of 373 outpatients who met criteria for major depressive disorder (MDD) (by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition-Patient Edition) and who were enrolled in the 8-week acute treatment phase of a study of fluoxetine for MDD. Sixty-four subjects who responded to fluoxetine treatment in the acute phase met criteria for remission throughout a 26-week continuation phase during which they remained on fluoxetine with or without cognitive behavioral therapy. Stability of PDs was defined as meeting criteria for a PD at both beginning and end point of the continuation treatment phase. RESULTS: Before fluoxetine treatment, anxious depressed patients (defined as meeting criteria for MDD as well as at least one comorbid anxiety disorder) were significantly more likely to meet criteria for any comorbid PD diagnosis compared with depressed patients without comorbid anxiety disorders. In particular, there was a significant relationship between the presence of Cluster A and C PDs and the presence of anxious depression at baseline before antidepressant treatment. After successful treatment of MDD, we found a significant relationship between anxious depression diagnosed at baseline and the stability of a Cluster C PD diagnosis. CONCLUSION: Anxious depression may place patients at greater risk of having a PD diagnosis, especially one from Cluster A or C. Once the depression remits, patients who initially met criteria for anxious depression may be more likely to maintain a Cluster C PD diagnosis compared with patients initially diagnosed with MDD alone.     

抑郁障碍与人格障碍的共病研究

目的　了解抑郁障碍患者中人格障碍的发生率,探讨抑郁障碍与人格障碍的共病情况。方法　使用SCID- Ⅱ对102例抑郁障碍患者进行人格障碍的评估,并与102例正常人群对照,对抑郁障碍组进行汉密尔顿抑郁量表(HAMD)评定。结果　抑郁障碍组人格障碍的发生率为51.9%,31.4%的患者被诊断为两种或以上的人格障碍,显著高于对照组的14.7%;女性抑郁障碍患者人格障碍的发生率(63.5%)显著多于男性患者(40.0%);重性抑郁症与心境恶劣患者人格障碍的共病率则无统计学差异(P>0.05);抑郁障碍患者中最常见的人格障碍类型为回避型、强迫型、消极型以及偏执型。结论　抑郁障碍患者中具有较高的人格障碍患病率,对抑郁障碍和人格障碍的共病应引起临床高度重视。     

Effect of comorbid anxiety, depressive, and personality disorders on treatment outcome of somatoform disorders.

Comorbid mental disorders of DSM-IV axis I and axis II have repeatedly been found to be a negative predictor for the treatment of axis I disorders, although recent contrary findings exist. Little is known about the effect of comorbidity on the therapy outcome of somatoform disorders. We compared three types of comorbidity, (1) personality disorders (PDs), (2) major depression (MDD) and anxiety (ANX) disorders, and (3) PDS and MDD and ANX, with regard to their relevance for the treatment outcome of somatoform disorders. One hundred twenty-six inpatients were assessed at least 4 weeks before admission to treatment, upon admission, and again at discharge. Somatoform, hypochondriacal, and depressive symptomatology, dysfunctional cognitions about body and health, dysfunctional social relationships, and other clinical characteristics were measured. Diagnostic assessments were based on the DSM-IV. Our findings suggest that none of the three types of comorbidity influence the therapy outcome of somatoform disorders or have a modifying effect on the level of psychopathology.     

Normal personality traits and comorbidity among phobic, panic and major depressive disorders

High comorbidity among anxiety and depressive conditions is a consistent but not well-understood finding. The current study examines how normal personality traits relate to this comorbidity. In the Baltimore Epidemiologic Catchment Area Follow-up Study, psychiatrists administered the full Schedules for Clinical Assessment in Neuropsychiatry to 320 subjects, all of whom completed the Revised NEO Personality Inventory. The disorders of interest were simple phobia, social phobia, agoraphobia, panic disorder, and major depression. Analyses were carried out with second-order generalized estimating equations. The unadjusted summary odds ratio (SOR - or weighted mean odds ratio) for all five disorders was 1.72 (95% confidence interval=1.21-2.46). Neuroticism, introversion, younger age, and female gender were all significant predictors of prevalence of disorders. After adjustment for the relationships between these personality and demographic predictors and prevalence, the association among disorders was much weaker (SOR=1.11, 95% CI=0.79-1.56). However, subjects with high extraversion had a SOR 213% as high (95% CI=102-444%) as those with low extraversion (1.60 vs. 0.75). Therefore, neuroticism and introversion are associated with increased comorbidity due to relationships in common with the prevalence of the different disorders. In contrast, extraversion is associated with increased comorbidity per se.     

The role of questioning environment,personality traits,depressive and anxiety symptoms in tinnitus severity perception

Psychological factors have been described as important for tinnitus severity, but attempts to incorporate them in one picture are sparse. This study investigated to what extent traits (personality), states (depressive and anxiety symptoms), sociodemographic factors and questioning environment influence tinnitus severity perception and how they interplay. Data were obtained from 212 subjects in a survey that was undertaken in 2016 at Vilnius University hospital and via internet. Measures included the Tinnitus Handicap Inventory (THI), Visual Analogue Scale (VAS), Hospital Anxiety and Depression Scale (HADS), Big Five Personality Dimensions Scale and sociodemographic questions. A series of stepwise forward and multiple regression analyses were undertaken to discover how factors interconnect. Female gender, age, living in rural area, but not level of education, were found to be associated with THI and HADS. Total HADS score and of both subscales were linked to scores on THI, VAS scales and all personality traits, except agreeableness (and consciousness for anxiety). Anxiety was the most important predictor for tinnitus severity, followed by depressive symptoms. Only neuroticism from personality dimensions was a predictor of THI score, whereas THI scores did not predict scores on neuroticism. All results in scales were higher in the internet group, except agreeableness and neuroticism, while extroversion correlated negatively with THI score only in the hospital group. Tinnitus severity was highly correlated with depressive, anxiety symptoms and neuroticism. Respondents recruited through internet had higher scores on most parameters. Results emphasize the importance of psychological factors in tinnitus management.     

The role of personality in anxiety disorders

It is widely believed that personality disorders and/or traits (PDT) have significant impact on the phenomenology, severity and consequently the treatment of anxiety disorders (AD). Specific PDT's are thought to be characteristic of certain types of AD's. However, little experimental data support these assumptions. The interpretation of the few comorbidity and outcome studies investigating the role of PDT's in anxiety is problematic from both theoretical and methodological points of view. The authors review what is known about the co-occurrence of PDT's and some of the AD's. Particular attention is paid to studies that demonstrate the alteration of PDT's as a result of successful treatment of an AD and to those assessing the difficulties encountered in the treatment of AD's in the presence of certain PDT's. Specific recommendations for much needed research are given.     

Pain-related anxiety and anxiety sensitivity across anxiety and depressive disorders

Fear–anxiety–avoidance models posit pain-related anxiety and anxiety sensitivity as important contributing variables in the development and maintenance of chronic musculoskeletal pain [Asmundson, G. J. G, Vlaeyen, J. W. S., & Crombez, G. (Eds.). (2004). Understanding and treating fear of pain. New York: Oxford University Press]. Emerging evidence also suggests that pain-related anxiety may be a diathesis for many other emotional disorders [Asmundson, G. J. G., & Carleton, R. N. (2005). Fear of pain is elevated in adults with co-occurring trauma-related stress and social anxiety symptoms. Cognitive Behaviour Therapy, 34, 248–255; Asmundson, G. J. G., & Carleton, R. N. (2008). Fear of pain. In: M. M. Antony & M. B. Stein (Eds.), Handbook of anxiety and the anxiety disorders (pp. 551–561). New York: Oxford University Press] and appears to share several elements in common with other fears (e.g., anxiety sensitivity, illness/injury sensitivity, fear of negative evaluation) as described by Reiss [Reiss, S. (1991). Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11, 141–153] and Taylor [Taylor, S. (1993). The structure of fundamental fears. Journal of Behavior Therapy and Experimental Psychiatry, 24, 289–299]. The purpose of the present investigation was to assess self-reported levels of pain-related anxiety [Pain Anxiety Symptoms Scale-Short Form; PASS-20; McCracken, L. M., & Dhingra, L. (2002). A short version of the Pain Anxiety Symptoms Scale (PASS-20): preliminary development and validity. Pain Research and Management, 7, 45–50] across several anxiety and depressive disorders and to compare those levels to non-clinical and chronic pain samples. Participants consisted of a clinical sample (n = 418; 63% women) with principal diagnoses of a depressive disorder (DD; n = 22), panic disorder (PD; n = 114), social anxiety disorder (SAD; n = 136), obsessive-compulsive disorder (OCD; n = 86), generalized anxiety disorder (GAD; n = 46), or specific phobia (n = 14). Secondary group comparisons were made with a community sample as well as with published data from a treatment-seeking chronic pain sample [McCracken, L. M., & Dhingra, L. (2002). A short version of the Pain Anxiety Symptoms Scale (PASS-20): preliminary development and validity. Pain Research and Management, 7, 45–50]. Results suggest that pain-related anxiety is generally comparable across anxiety and depressive disorders; however, pain-related anxiety was typically higher (p < .01) in individuals with anxiety and depressive disorders relative to a community sample, but comparable to or lower than a chronic pain sample. Results imply that pain-related anxiety may indeed be a construct independent of other fundamental fears, warranting subsequent hierarchical investigations and consideration for inclusion in treatments of anxiety disorders. Additional implications and directions for future research are discussed.     

错误相关负电位在焦虑障碍、抑郁症中的应用

错误相关负电位(error-related negativity,ERN)本质上属于事件相关电位,典型的ERN是错误行为发生后50～100 ms,或错误行为发生当时出现的一个负波,波幅约10μV[1].一般认为,ERN反映了个体对错误的监测及处理,即在一次犯错后为防止短时间内再次出现类似错误而进行的自我调整.多种反应模式和不同难度的任务都可以引出ERN,其在头皮的分布以额中央区[2]为主,通过源定位研究[3]、脑磁波记录[4]以及脑内记录[5]推测,ERN产生于前扣带回皮质(anterior ingulate cortex,ACC).     

Anxiety,personality and anxiety disorders

The roles of trait anxiety, locus of control and defense style in the genesis and maintenance of anxiety are described. A model of the genetic and environmental determinants of these three measures is presented. The contributions that such vulnerability factors make to anxiety and the anxiety disorders is estimated and discussed in relation to the issue of co-moribidity and the general neurotic syndrome. Some evidence is presented about the specificity of the various anxiety disorders even though other conditions may have co-occurred, for they are often found to be secondary to the index condition. Such a two-factor theory of neurosis, one that implies both a general vulnerability due to high trait anxiety and poor coping, and an independent but specific vulnerability to a particular disorder, will make definitive research very complex. Aetiological factors or treatments that are believed to be specifically associated with only one disorder will have to be shown to be associated with that disorder alone and not with other anxiety disorders or with asymptomatic normals high on these general vulnerability factors.     

The association between personality traits,cognitive reactivity and body mass index is dependent on depressive and/or anxiety status

ObjectiveA range of biological, social and psychological factors, including depression and anxiety disorders, is thought to be associated with higher body mass index (BMI). Depression and anxiety disorders are associated with specific psychological vulnerabilities, like personality traits and cognitive reactivity, that may also be associated with BMI. The relationship between those psychological vulnerabilities and BMI is possibly different in people with and without depression and anxiety disorders. Therefore, we examined the relationship between personality traits, cognitive reactivity and severity of affective symptoms with BMI in people with and without depression and anxiety disorders.MethodsData from 1249 patients with current major depressive and/or anxiety disorder and 631 healthy controls were sourced from the Netherlands Study of Depression and Anxiety. Linear and logistic regression analyses were used to determine the associations between personality traits (neuroticism, extraversion, conscientiousness), cognitive reactivity (hopelessness, aggression, rumination, anxiety sensitivity), depression and anxiety symptoms with BMI classes (normal: 18.5–24.9, overweight: 25–29.9, and obese: ≥ 30 kg/m²) and continuous BMI. Due to significant statistical interaction, analyses were stratified for healthy individuals and depressed/anxious patients.ResultsPersonality traits were not consistently related to BMI. In patients, higher hopelessness and aggression reactivity and higher depression and anxiety symptoms were associated with higher BMI. In contrast, in healthy individuals lower scores on hopelessness, rumination, aggression reactivity and anxiety sensitivity were associated with higher BMI.ConclusionThese results suggest that, particularly in people with psychopathology, cognitive reactivity may contribute to obesity.     

The relationship between borderline personality disorder and anxiety disorders

Eleven "pure" borderlines, ten borderlines with depression, 16 "pure" depressives, and 31 normal subjects were compared on a number of standardized inventories of anxiety. While patient groups experienced more anxiety of all types than did normals, borderlines did not emerge as more anxious than other patient groups. Qualitative differences in the anxiety experienced by borderlines and nonborderlines are discussed.     

Personality traits predict current and future functioning comparably for individuals with major depressive and personality disorders

Axes I and II were separated in DSM-III to encourage the consideration of the influence of both personality and psychopathology on patient behavior, on the assumption that an understanding of personality would increment syndromal diagnosis in treatment decisions. However, in practice the distinction between Axis I and Axis II is less clear. The current report investigates one aspect on which Axis I and Axis II might be expected to differ, that being the the significance of normative personality traits as an influence on functional status. In this study, the contribution of normative personality traits to functioning is presented for 2 groups of patients, one with major depression and a second with personality disorders. The data suggest that personality traits are significant and equally relevant predictors of functioning for both groups. The utility of assessing personality traits for individuals with both Axis I and II disorders is thus supported.     

The impact of aversive personality traits on the psychotic-spectrum of disorders

ObjectivesThough relatively unexplored in clinical populations, aversive personality traits have been shown to impact the expression, the management, and the outcomes of psychotic disorders. This paper seeks to gather and organize existing evidence of the complex interplay linking social ethics, personality and experiences of psychosis through the lens of the so-called Dark Triad personality model, comprising the three multidimensional constructs Machiavellianism, narcissism and psychopathy.MethodsA semi-systematic review of major literature databases was conducted; search terms aimed at capturing each of the Dark Triad dimensions and their known relations with both clinical (with single-symptom approach) and non-clinical psychotic experiences.ResultsReviewed studies suggest that all the components of the Dark Triad model present significant clinical implications in the management of psychotic disorders.ConclusionsAversive personality traits interact with and modulate the experiences of psychosis. They can be shown to influence the clinical and functional outcomes of psychotic patients. Therefore, further research on this theme seems justified in that it may inform rehabilitative efforts.     

Quality-of-life impairment in depressive and anxiety disorders

OBJECTIVE: Previous reports demonstrating quality-of-life impairment in anxiety and affective disorders have relied upon epidemiological samples or relatively small clinical studies. Administration of the same quality-of-life scale, the Quality of Life Enjoyment and Satisfaction Questionnaire, to subjects entering multiple large-scale trials for depression and anxiety disorders allowed us to compare the impact of these disorders on quality of life. METHOD: Baseline Quality of Life Enjoyment and Satisfaction Questionnaire, demographic, and clinical data from 11 treatment trials, including studies of major depressive disorder, chronic/double depression, dysthymic disorder, panic disorder, obsessive-compulsive disorder (OCD), social phobia, premenstrual dysphoric disorder, and posttraumatic stress disorder (PTSD) were analyzed. RESULTS: The proportion of patients with clinically severe impairment (two or more standard deviations below the community norm) in quality of life varied with different diagnoses: major depressive disorder (63%), chronic/double depression (85%), dysthymic disorder (56%), panic disorder (20%), OCD (26%), social phobia (21%), premenstrual dysphoric disorder (31%), and PTSD (59%). Regression analyses conducted for each disorder suggested that illness-specific symptom scales were significantly associated with baseline quality of life but explained only a small to modest proportion of the variance in Quality of Life Enjoyment and Satisfaction Questionnaire scores. CONCLUSIONS: Subjects with affective or anxiety disorders who enter clinical trials have significant quality-of-life impairment, although the degree of dysfunction varies. Diagnostic-specific symptom measures explained only a small proportion of the variance in quality of life, suggesting that an individual's perception of quality of life is an additional factor that should be part of a complete assessment.