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1.

Objective

This study examined evidence for personality variability in adolescents with eating disorder features in light of previous evidence that personality variability in adult women with eating disorder symptoms carries important clinical implications.

Method

Millon Adolescent Clinical Inventory personality data from adolescent girls with disturbed eating who were psychiatrically hospitalized were cluster analyzed, and resulting groups were compared in eating and comorbid psychopathology.

Results

Three subgroups were identified among the 153 patients with eating disorder features: high functioning, internalizing, and externalizing. The internalizing group was marked by eating-related and mood dysfunction; the externalizing group by elevated eating and mood psychopathology as well as impulsivity, aggression, and substance use; and the high-functioning group by lower levels of psychopathology and relatively high self-esteem.

Conclusions

These findings converge with previous research using different personality models in adult samples and highlight the clinical use of considering personality heterogeneity among adolescent and adult women with disturbed eating.  相似文献   

2.

Objective

Increased weight concern and dieting are associated with both depression and smoking among adolescents, particularly girls. This cross-sectional study examined the gender-specific role of weight concerns and dieting on the adolescent depression-smoking association.

Methods

Participants were 2051 adolescents (1056 boys and 995 girls) from seven high schools in the Netherlands who filled out questionnaires on smoking, depression, and weight constructs and of whom weight and height were measured.

Results

Logistic regression analyses showed that for girls, but not for boys, the depression-smoking association disappeared after controlling for weight concerns and dieting.

Conclusion

Our findings indicate that weight concerns and dieting are important factors to consider in the depression-smoking initiation relation for girls, but not for boys. This suggests that smoking prevention programs for depressed girls might be enhanced by challenging the idea of smoking as a diet strategy and incorporating a focus on healthy weight regulation. However, before setting up a prevention trial, future prospective studies should first examine why and how weight concerns and dieting are important factors in the depression-smoking initiation relation among girls, also in conjunction with other established risk factors such as parental and peer smoking.  相似文献   

3.

Objective

Body dysmorphic disorder (BDD) is relatively common and appears to be associated with marked impairment in psychosocial functioning. Previous reports, however, did not investigate occupational functioning in detail, assess impairment specifically in occupational functioning using standardized measures in a nontreatment seeking sample, or examine correlates of occupational impairment.

Methods

Occupational functioning and other clinical variables were assessed in 141 adults with BDD. Measures included the Range of Impaired Functioning Tool and other reliable and valid self-report and interviewer-administered measures.

Results

Fewer than half of subjects were working full-time, and 22.7% were receiving disability pay. Thirty-nine percent of the sample reported not working in the past month because of psychopathology. Of those subjects who worked in the past month, 79.7% reported impairment in work functioning because of psychopathology. Adults with BDD who were not working because of psychopathology were comparable to subjects who were working in most demographic variables, delusionality of BDD beliefs, and duration of BDD. However, compared to subjects who worked in the past month, those not currently working because of psychopathology had more severe BDD and more chronic BDD. They also were more likely to be male, had less education, and had more severe depressive symptoms, a higher rate of certain comorbid disorders, poorer current social functioning and quality of life, a higher rate of lifetime suicidality, and were more likely to have been psychiatrically hospitalized.

Conclusions

A high proportion of individuals with BDD were unable to work because of psychopathology; most who worked reported impairment in occupational functioning. Certain clinical variables, including more severe and chronic BDD, were associated with not working.  相似文献   

4.

Objective

Recent research has suggested a move toward a dimensional system for the classification of personality disorders (PDs). Tyrer's dimensional model using severity as a form of categorizing PDs was used to compare eating disorder outcome in women with bulimia nervosa (BN) over 3 years.

Method

One hundred thirty-four women with BN were divided into 4 groups based on PD severity: no PD (n = 32), personality difficulty (n = 27), simple PD (n = 29), and complex PD (n = 46). Eating disorder symptoms and attitudes, general psychosocial functioning, and depressive symptoms were examined at pretreatment and at 1-year and 3-year follow-up (posttreatment).

Results

The complex PD group had greater Axis I comorbidity and psychopathology than the remaining 3 groups at pretreatment. At 1-year and 3-year follow-up, there were no differences in eating disorder outcome, general psychosocial functioning, and depressive symptoms across the 4 groups.

Conclusion

These results suggest that having an increased number of PDs comorbid with BN does not influence eating disorder outcome up to 3 years after treatment.  相似文献   

5.

Objective

Nonsuicidal deliberate self-harm and factitious disorders have been proposed as subtypes within the autodestructive behavior spectrum, basically differing in the issue of concealment. Aims are to determine Axis I diagnoses and psychopathologic correlates of open self-harmers and patients diagnosed with factitious disorders.

Methods

One hundred ninety-four psychosomatic medicine inpatients participated. Assessment included the structured World Health Organization Composite International Diagnostic Interview (computerized version) and self-report questionnaires for anxiety, depression, perceived stress, and personal coping resources.

Results

Thirty-seven patients identified with self-destructive behavior were matched with 37 patients without such behavior. Overt self-harmers (n = 18) were more frequently diagnosed with anxiety, depressive, substance abuse/dependence, or eating disorders and reported more stress than factitious disorder patients (n = 19) or those without self-destructive behavior. Patients with factitious disorder exhibited lower Axis I comorbidity and less psychopathology than patients without self-harm behavior.

Conclusions

Regarding psychopathologic assessment, contrary to open self-harmers, factitious disorder patients appear strikingly inconspicuous.  相似文献   

6.

Objective

The purpose of this study is to analyze the developmental relationships of adolescent-onset Axis I mental disorders and eating disorders (EDs).

Method

One thousand three hundred eighteen adolescent twins born from 1983 to 1987 completed a professionally administered semistructured psychiatric interview at the age of 14 years and a questionnaire follow-up at the age of 17.5 years.

Results

Eating disorders at the age of 17.5 years were significantly predicted by major depressive disorder (odds ratio, 5.9; 95% confidence interval, 2.6-15.3) and generalized anxiety disorder (GAD) (odds ratio, 4.7; 95% confidence interval, 1.8-15.6) at the age of 14 years, when baseline EDs were excluded. Early-onset major depressive disorder in combination with GAD increased the likelihood of developing EDs compared with either mood or anxiety disorders alone. Similar risks and trends were evident in within-family analyses of twin pairs discordant for baseline predictors and ED outcome.

Conclusions

Depressive disorder and GAD that manifest at that age of 14 years predict future EDs. Analysis of discordant twins suggested that early-onset depressive disorder and GAD prospectively relate to EDs in adolescence, even after familial factors are taken into account.  相似文献   

7.

Theory/objective

Somatoform disorder (SFD) is associated with considerable psychosocial impairment. However, only a few studies have dealt with the course of this clinical subgroup. Therefore, the objective was to identify predictors for the various courses of SFD and medically unexplained symptoms (MUS).

Method

We screened 620 consecutive patients in primary care using the Patient Health Questionnaire (PHQ-15). Afterwards, 308 patients were studied in more detail using a diagnostic interview and a set of questionnaires. One year later, we were able to interview 277 participants a second time.

Result

After 1 year, 48.8% of the respondents had a remitted SFD. The following variables proved to be significant predictors of MUS: current depressive episode, negative life events, number of MUS at baseline, attributional style, autonomic sensations and catastrophizing cognitions. The course of SFD could be predicted through current depressive or anxiety disorder, negative life events, functional disability and attributional style.

Conclusion

Somatoform disorder has a favorable course. The predictors of the courses of SFD and MUS we found can be integrated into previous explanatory models. The coping with MUS or SFD can be seen as a mediating factor.  相似文献   

8.

Objective

Parenting and family dynamics influence the emergence, development, and maintenance of eating disorders (EDs). Although family interventions are relevant for therapeutic programs, knowledge of the relationship between parental personality traits and the eating psychopathology of daughters is scarce. This study explored the personality and psychopathology of women with EDs and correlated them with parental personality traits.

Method

The personality and eating psychopathology traits of 38 restricter anorectics, 30 bingeing/purging anorectics, 37 bulimics, and their parents' personality traits (87 fathers and 97 mothers) were measured with the Temperament and Character Inventory, the Clinical Global Impression Scale, the Eating Disorders Inventory-2, and the Beck Depression Inventory. The results were compared with matched controls (54 women, 50 fathers, 54 mothers). Personality and psychopathology were correlated with multiple regression.

Results

Women with ED displayed high harm avoidance and low self-directedness, whereas restricter anorectic women had high persistence. Low persistence was common in fathers of daughters across all EDs. Fathers of restricter anorectics were highly harm avoidant. Fathers of both anorectic subtypes and mothers of bulimic women displayed low self-directedness. Parental personality traits were linearly correlated with their daughter's personality and psychopathology, but the correlation differed among EDs.

Conclusion

Parents of eating-disordered participants displayed personality characteristics that differed from controls and, among ED subgroups, these differences were related to their daughter's personality and psychopathology. The linear correlation did not fully explain the relationship of the parental personality traits to the presence of their daughter's ED, suggesting that a more complex personality-based family dynamic is involved. A Temperament and Character Inventory profile of the entire family may be used in the planning of family treatment.  相似文献   

9.

Objective

We examined correlates of avoidant and obsessive-compulsive personality pathology—with respect to psychiatric comorbidity, eating disorder psychopathology, and associated psychologic factors—in patients with binge-eating disorder (BED).

Method

Three hundred forty-seven treatment-seeking patients who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), research criteria for BED were reliably assessed with semistructured interviews to evaluate DSM-IV Axis I disorders, personality disorders, and behavioral and attitudinal features of eating disorder psychopathology.

Results

Fifteen percent of subjects had avoidant personality disorder features, 12% had obsessive-compulsive personality disorder features, 8% had features of both disorders, and 66% had features of neither. These groups differed significantly in the frequencies of depressive and anxiety disorders, as well as on measures of psychologic functioning (negative/depressive affect and self-esteem) and eating disorder attitudes (shape and weight concerns). There were no group differences on measures of eating behaviors. The avoidant and obsessive-compulsive groups had more psychiatric comorbidity than the group without these personality features but less than the combined group. The group without these features scored significantly lower than all other groups on negative/depressive affect and significantly higher than the avoidant and combined groups on self-esteem. The combined group had the greatest severity on shape and weight concerns.

Conclusions

Avoidant and obsessive-compulsive personality features are common in patients with BED. Among BED patients, these forms of personality psychopathology—separately and in combination—are associated with clinically meaningful diagnostic, psychologic, and attitudinal differences. These findings have implications for the psychopathologic relationship between BED and personality psychopathology and may also have implications for assessment and treatment.  相似文献   

10.

Objective

The primary aim of this study was to investigate whether depressive symptoms were significantly associated with functional outcome measures in a clinically stable group of outpatients with schizophrenia. We also analyzed whether depressive and negative symptoms presented different patterns of predictors.

Method

Seventy-eight consecutive outpatients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria for schizophrenia in the stable period were enrolled in this cross-sectional study. Assessment were performed using the Calgary Depression Scale for Schizophrenia, Positive and Negative Syndromes Scale (PANSS), Clinical Global Impression Scale-severity, Social and Occupational Functioning Assessment Scale, Sheehan Disability Scale, and Quality of Life Scale. A neuropsychologic battery including the vocabulary and block design subtests of the Wechsler Adult Intelligence Scale-Revised, Wechsler Memory Scale, Wisconsin Card Sorting Test, and Continuous Performance Test was also administered to the patients. Two multiple regressions were performed testing demographic and clinical factors, rating scales, and cognitive measures as independent variables and Calgary Depression Scale for Schizophrenia and PANSS-negative subscale scores as dependent variables.

Results

Four variables were predictors of depressive symptoms in our sample of schizophrenic patients: 2 outcome measures (Sheehan Disability Scale and Quality of Life Scale), gender, and Continuous Performance Test reaction time. Predictors of negative symptoms were the measures of severity of psychopathology (Clinical Global Impression Scale-severity and PANSS-general psychopathology subscale) and the cognitive tests Wechsler Adult Intelligence Scale-Revised block design and Wechsler Memory Scale.

Conclusion

We found that depressive symptoms in schizophrenia are mainly a function of the level of social adjustment and quality of life, whereas negative symptoms constitute an indicator of severity of schizophrenia. The 2 symptom dimensions showed also distinct cognitive correlates.  相似文献   

11.

Objective

Previous research has found an association between sleep problems and suicidal behavior. However, it is still unclear whether the association can be largely explained by depression. In this study, we prospectively examined relationships between sleep problems when participants were 12-14 years old and subsequent suicidal thoughts and self-harm behaviors—including suicide attempts—at ages 15-17 while controlling for depressive symptoms at baseline.

Methods

Study participants were 280 boys and 112 girls from a community sample of high-risk alcoholic families and controls in an ongoing longitudinal study.

Results

Controlling for gender, parental alcoholism and parental suicidal thoughts, and prior suicidal thoughts or self-harm behaviors when participants were 12-14 years old, having trouble sleeping at 12-14 significantly predicted suicidal thoughts and self-harm behaviors at ages 15-17. Depressive symptoms, nightmares, aggressive behavior, and substance-related problems at ages 12-14 were not significant predictors when other variables were in the model.

Conclusions

Having trouble sleeping was a strong predictor of subsequent suicidal thoughts and self-harm behaviors in adolescence. Sleep problems may be an early and important marker for suicidal behavior in adolescence. Parents and primary care physicians are encouraged to be vigilant and screen for sleep problems in young adolescents. Future research should determine if early intervention with sleep disturbances reduces the risk for suicidality in adolescents.  相似文献   

12.

Objective

The aim of the present study was to compare 3 months percent body fat (PBF) and body mass index (BMI) in children with severe visual impairment enrolled in goalball and movement education.

Methods

Participants were 24 boys and 22 girls with visual impairment, 10-15 years of age (M = 12.5 years, SD = 1.5). Skin-fold measurements were performed on the right side of the body by using Holtain® calipers.

Results

Both BMI and PBF reduced in boy and girl goalball players. PBF reduced in both boys and girls of movement education group; BMI increased in boys and decreased in girls. In girls, reduction in PBF was higher in goalball group than in movement education group.

Conclusions

Maturation confounds these data but movement education in especially boys and goalball in especially girls may contribute physical and/or motor fitness.  相似文献   

13.

Background

Depressive symptoms are common in schizophrenia and are considered core features of the disorder. The purpose of the present study was to examine the relationship between depressive symptoms and subjective well-being in newly admitted patients with schizophrenia.

Methods

Eighty newly admitted patients were comprehensively evaluated for subjective well-being, schizophrenic symptoms, and depressive symptoms using the Subjective Well-Being Under Neuroleptics Scale (SWN), the Positive and Negative Syndrome Scale (PANSS), and the Beck Depression Inventory. Correlation coefficients were obtained between depressive symptoms and subjective well-being while controlling for the influence of the severity of psychotic symptoms, extrapyramidal side effect, and subjective attitude toward antipsychotics, as assessed by the PANSS, the Drug-Induced Extrapyramidal Symptoms Scale, and the Drug Attitude Inventory, respectively.

Results

The SWN score had a significant negative correlation with the PANSS depression factor score (P < .001). Correlation analysis also revealed a significant negative correlation between the SWN score and the Beck Depression Inventory score (P < .001).

Conclusions

The results of our study suggest that depressive symptoms are significantly associated with a low subjective well-being in newly admitted patients with schizophrenia and that the relationship is significant even after controlling for the influence of potential confounding variables. Detection and appropriate management of depressive symptoms in schizophrenic patients may affect their perceptions of their own well-being.  相似文献   

14.

Objective

This college-based questionnaire survey aimed to explore the individual, family, and peer correlates for cigarette smoking among first-year college students.

Method

The sample included 2918 first-year college students (males, 45.5%) recruited from a national university in Taiwan (participation rate, 79.1%). The participants reported on questions about various substances, attitudes toward substances, personality characteristics, psychopathology, suicidal behaviors, parenting style, family function and use of substances, and peer substance use.

Results

There were 263 (9.0%; males, 70.6%) current smokers. Compared to nonsmokers, college smokers were more extraverted and neurotic, and showed less harm avoidance, and more novelty seeking in their personality. They had more hostile, somatic, depressive, paranoid, and psychotic symptoms in terms of psychopathology. Smokers were more likely to use other substances, and to have suicidal ideations, wishes, plans, and attempts. Smokers perceived lower family cohesion, less care from their fathers, and less overprotection from their mothers. They were more likely to have peers and family members who also smoked or used other substances. The most associated correlates were male sex, older age, other substance use, novelty seeking, suicidal ideation and attempts, sibling and peer substance use, a prosubstance attitude, and less maternal overprotection.

Conclusions

Our findings support the association of cigarette use in Taiwanese young adults with several individual, family, and peer factors identified in Western studies. Intervention in cigarette use should be multifaceted, by taking its correlates and the concurrent psychopathology, use of substances, and suicidality into consideration.  相似文献   

15.

Objective

This study evaluated a population of outpatients with stable schizophrenia to analyze if relationships between patterns of symptomatology and quality of life (QOL) change during the time course of illness.

Methods

We recruited 168 outpatients with stable schizophrenia, and we further divided our sample into 3 groups of patients (≤36, 37-72, and >72 months of illness). Psychiatric assessment included the Quality of Life Scale, the Positive and Negative Syndrome Scale, the Calgary Depression Scale for Schizophrenia, and the Clinical Global Impression-Severity Scale. All clinical variables significantly related to Quality of Life Scale scores were subsequently analyzed using a multiple stepwise regression to assess their independent contribution to QOL in the 3 patient groups.

Results

Quality of life and symptoms profiles were similar among patient groups. After controlling for potentially confounding variables, multiple regression revealed that depressive symptoms appeared to have a stronger relationship with QOL during the early 3-year course of the illness.In the period between 4 and 6 years of illness, negative symptoms were the most reliable predictors of QOL. After the 6-year course of illness, negative symptoms remained the most reliable predictors of QOL, together with severity of illness, whereas positive and depressive symptoms had a minor role.

Conclusions

Despite similar QOL and symptoms profiles, these findings suggested that relationships among patterns of symptomatology and QOL change during the course of schizophrenia.  相似文献   

16.

Background

In children with loss of control (LOC) over eating, recent research has revealed evidence for distinct personality features, such as more impulsivity. The aim of this study was to assess parent- and child-report personality profiles in children with and without LOC over eating and to relate these profiles to general and eating-disorder psychopathology.

Method

A total of 120 children (60 with LOC over eating; 68 girls) aged 8 to 13 years were recruited from the community. Clinical interview, self-report, and parent-report questionnaires were administered to assess personality as well as both general and eating-disorder psychopathology.

Results

The group with LOC over eating showed lower self-directedness and cooperativeness compared to the group without LOC. The children with LOC were significantly more impulsive. Personality dimensions were significantly correlated with greater general but not eating-disorder psychopathology and frequency of LOC over eating.

Conclusion

A distinct pattern of personality traits in children with LOC over eating was found that is partly in line with research on binge-eating disorder, bulimia nervosa, and obesity in adulthood. The findings suggest that longitudinal studies should examine whether certain patterns of personality in children with LOC over eating account for differences in psychopathology later in life.  相似文献   

17.

Objective

Two types of sleep preference have been supported in the literature. Morning types awaken early and are refreshed upon waking, whereas Evening types rise later and have more erratic sleep schedules. Sleep affects menstrual functioning in adult women. However, there is scant research on the association between sleep preference and menstrual functioning in adolescents. Thus, the present study examined the association between sleep preference and menstrual functioning in 210 adolescent girls (11-17 years old).

Methods

Data represent baseline measures from a longitudinal study examining the association of psychological functioning and smoking with reproductive and bone health. Measures included the Menstrual Symptom Questionnaire (MSQ), regularity and duration of menstrual cycles, and the Morningness/Eveningness scale (measuring sleep preference). MSQ factor scores were used in analyses: abdominal pain, negative affect/somatic complaints, back pain, and anxiety/fatigue.

Results

The results from hierarchical linear regression analyses showed significant associations between Evening preference and more symptoms of abdominal pain (P<.01), negative affect/somatic complaints (P<.01), anxiety/fatigue (P<.01), and shorter menses (P<.05).

Conclusion

Adolescent girls with Evening preference experience more menstrual symptoms than those with Morning preference. Future research should include sleep preference in studies of health and behavior particularly in adolescence when there is a normative shift toward Evening preference.  相似文献   

18.

Objective:

Adolescent mothers are at increased risk of mistreating their children. Intervening before they become pregnant would be an ideal primary prevention strategy. Our goal was to determine whether psychopathology, exposure to maltreatment, preparedness for child-bearing, substance use disorders (SUDs), IQ, race, and socioeconomic status were associated with the potential for child abuse in nonpregnant adolescent girls.

Method:

The Child Abuse Potential Inventory (CAPI) was administered to 195 nonpregnant girls (aged 15 to 16 years; 54% African American) recruited from the community. Psychiatric diagnoses from a structured interview were used to form 4 groups: conduct disorder (CD), internalizing disorders (INTs; that is, depressive disorder, anxiety disorder, or both), CD + INTs, or no disorder. Exposure to maltreatment was assessed with the Childhood Trauma Questionnaire, and the Childbearing Attitudes Questionnaire measured maternal readiness.

Results:

CAPI scores were positively correlated with all types of psychopathology, previous exposure to maltreatment, and negative attitudes toward child-bearing. IQ, SUDs, and demographic factors were not associated. Factors associated with child abuse potential interacted in complex ways, but the abuse potential of CD girls was high, regardless of other potentially protective factors.

Conclusions:

Our study demonstrates that adolescent girls who have CD or INT are at higher risk of perpetrating physical child abuse when they have children. However, the core features of CD may put this group at a particularly high risk, even in the context of possible protective factors. Treatment providers should consider pre-pregnant counselling about healthy mothering behaviours to girls with CD.  相似文献   

19.

Objective

Personality and childhood trauma may affect cardiovascular disease (CVD) risk. However, evidence for an association with metabolic risk factors for CVD is limited and ambiguous. Moreover, despite their interrelatedness, personality and childhood trauma were not yet studied simultaneously. Therefore, we aimed to explore whether personality and childhood trauma are correlates of metabolic risk factors.

Methods

Among 2755 participants of the Netherlands Study of Depression and Anxiety (NESDA), we investigated through linear regression models whether Big Five personality traits (i.e., extraversion, openness, agreeableness, neuroticism and conscientiousness) and childhood trauma type (i.e., emotional neglect, and psychological, physical and sexual abuse) were correlates of metabolic risk factors (i.e., lipids, waist circumference (WC), glucose and blood pressure). Basic covariates (i.e., age, sex and income level), lifestyle, severity of depressive symptoms and years of education were taken into account.

Results

Openness was the most robust favorable correlate, and sexual abuse was the most robust unfavorable correlate of lipids and WC, and of overall metabolic risk (β = −.070; p < .001 and β = .035; p = .04, respectively).

Conclusions

People with a low openness trait and those who experienced childhood sexual abuse are at higher risk of dyslipidemia and abdominal obesity.  相似文献   

20.

Objective

Attentional bias to emotion- and illness-related information plays a prominent role in many mental disorders, particularly major depressive disorder and anxiety disorders. Using the emotional Stroop task we investigated which variables beyond aspects of patients' psychopathology might influence reaction times and interference in the Stroop test.

Methods

We investigated 82 psychosomatic inpatients and 39 healthy controls. Diagnosis of depressive disorders, anxiety disorders, and somatoform disorders were established using the Structured Clinical Interview for DSM-IV. Severity of depression, anxiety, somatic symptoms, as well as experiences of childhood trauma, alexithymia, dissociation and emotion suppression were assessed via questionnaires. The emotional Stroop test was performed by using neutral and negative words, words related to depression, anxiety and somatization, respectively, and individually chosen words, which were related to the main problems of the participants.

Results

In multivariate regression analyses, reaction times were best predicted by self-reported experiences of childhood trauma. Interference, by contrast, was predicted by emotion suppression, but only for negative words, anxiety-related words and individually relevant words. Against our hypothesis, measurements of psychopathology were not associated with Stroop performance.

Conclusions

The present study provides further support for the idea that the experience of childhood trauma influences adult neuropsychological performance. Furthermore, the findings suggest that the ability to suppress emotions may be an important predictor of attentional bias.  相似文献   

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