Confirmatory factor analysis and measurement invariance by gender,age and levels of psychological distress of the short TEMPS-A

Background

The Temperament Evaluation of Memphis, Pisa, Paris and San Diego – Autoquestionnaire (TEMPS-A) is a widely used self-reported tool aimed at measuring the affective temperaments that define the bipolar spectrum, with cyclothymic, depressive, irritable, hyperthymic, and anxious subscales. Confirmatory factor analysis (CFA) was rarely used to confirm the expected five-factor model. Measurement invariance was never tested.

Methods

Cross-sectional, survey design involving 649 Italian college students (males: 47%). The short 39-item TEMPS-A and the 12-item General Health Questionnaire (GHQ-12) were used as measures of the affective temperaments and of psychological distress, respectively. CFA was applied to the TEMPS-A. Measurement invariance by gender, age and levels of psychological distress on the GHQ-12 was calculated with the establishment of subsequent equivalence constraints in the model parameters across groups.

Results

The expected five-factor model had the best fit for all CFA indexes. Configural, metric and scalar invariance of the five-factor model of the TEMPS-A was proved across gender, age and levels of psychological distress of the participants. The hyperthymic temperament subscale has low or no links with the other affective temperament subscales, which were interrelated with medium to large effect sizes.

Limitations

College students might be not representative of the general population. No information on the clinical status of the students was available beyond self-report data.

Conclusion

The study proved the measurement invariance of the (short) TEMPS-A, which is a pre-requisite to compare groups or individuals in cross-sectional and longitudinal surveys. Generalizability cannot be assumed without replication of the findings in clinical samples.     

Dimensional endophenotypes in bipolar disorder: Affective dysregulation and psychosis proneness

Background

The clinical phenotype of bipolar disorder (BPD) is heterogeneous and the genetic architecture of the disorder is complex and not well understood. Given these complications, it is possible that the identification of intermediate phenotypes (“endophenotypes”) will be useful in elucidating the complex genetic mechanisms that result in the disorder. The examination of unaffected relatives is critical in determining whether a particular trait is genetically-relevant to BPD. However, few dimensional traits related to BPD have been assessed in unaffected relatives of patients.

Methods

We assessed affective temperament and schizotypy in 55 discordant sibling pairs and 113 healthy controls (HCs) using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego, Auto-questionnaire version (TEMPS-A) to assess affective temperament and the Schizotypal Personality Questionnaire (SPQ) to assess schizotypy.

Results

BPD patients scored significantly higher than HCs on all subscales of the SPQ and on all but one subscale (hyperthymic) of the TEMPS-A (all p<0.01). Siblings demonstrated scores that were significantly intermediate to patients and HCs on the anxious subscale of the TEMPS-A and on the interpersonal deficits and disorganized subscales of the SPQ.

Limitations

We did not investigate the BPD spectrum as most patients were diagnosed with BPD I (n=47). Most of the patients had experienced psychosis (n=42) and so we were unable to examine whether psychosis status impacted upon affective temperament or schizotypy in patients or their siblings.

Conclusion

These data suggest that schizotypy and affective temperament represent dimensional traits that are likely to underlie the genetic risk for BPD.     

Attachment,affective temperament,and personality disorders: A study of their relationships in psychiatric outpatients

Background

As the result of extensive translational and cross-disciplinary research, attachment theory is now a construct with significant neuropsychiatric traction. The correlation of attachment with other influential conceptual models (i.e. temperament and personality) is therefore of interest. Consequently, we explored how two attachment dimensions (attachment anxiety and attachment avoidance) correlated with measures of temperament and personality in 357 psychiatric outpatients.

Methods

We performed a retrospective review of four questionnaires (the Experiences in Close Relationship scale (ECR-R), Temperament and Character inventory (TCI), Temperament Evaluation of the Memphis, Pisa, Paris and San Diego questionnaire (TEMPS-A), and Personality Self-Portrait Questionnaire (PSQ)). Frequency measures and correlations were examined, as was the predictive value of attachment security for a personality disorder (PD).

Results

Significant, robust correlations were found between attachment anxiety and (1) several negative affective temperaments (dysthymic and cyclothymic); (2) several indices of personality pathology (low self-directedness (TCI), DSM-IV paranoid, borderline, histrionic, avoidant and dependent personality traits). Attachment avoidance had fewer large correlations. In an exploratory model, the negative predictive value of attachment security for a PD was 86%.

Limitations

Subjects were a relatively homogeneous subset of ambulatory psychiatric outpatients. PD diagnoses were via self-report.

Conclusions

Clinically, these findings highlight the significant overlap between attachment, affective temperament, and personality and support the value of attachment as a screen for PDs. More broadly, given our growing understanding of the neurobiology of attachment (i.e. links with the oxytocin system), these results raise interesting questions about underlying biological systems and psychiatric treatment.     

A combined application of lossless and lossy compression in ECG processing and transmission via GSM-based SMS

Abstract

This paper presents a software-based scheme for reliable and robust Electrocardiogram (ECG) data compression and its efficient transmission using Second Generation (2G) Global System for Mobile Communication (GSM) based Short Message Service (SMS). To achieve a firm lossless compression in high standard deviating QRS complex regions and an acceptable lossy compression in the rest of the signal, two different algorithms have been used. The combined compression module is such that it outputs only American Standard Code for Information Interchange (ASCII) characters and, hence, SMS service is found to be most suitable for transmitting the compressed signal. At the receiving end, the ECG signal is reconstructed using just the reverse algorithm. The module has been tested to all the 12 leads of different types of ECG signals (healthy and abnormal) collected from the PTB Diagnostic ECG Database. The compression algorithm achieves an average compression ratio of ～22.51, without any major alteration of clinical morphology.     

综合心理健康教育对劳动密集型企业产业工人抑郁早期识别的干预效果

目的:了解综合心理健康教育对劳动密集型企业产业工人抑郁早期识别的干预效果,以便在更多的劳动密集型企业推广,提高工人抑郁早期识别能力及总体心理健康水平.方法:选取深圳有代表性的某劳动密集型企业的A、B两个厂区分别作为综合心理健康教育干预产区和非干预产区,然后利用抽签法从A厂区的9个车间中抽取1个车间作为综合心理健康教育干预组(简称干预组),从B厂区的9个车间中抽取1个车间作为非干预对照组.干预组接受为期6个月,每月至少1项干预措施的综合心理健康教育,对照组按照常规管理.用自编的心理健康教育需求状况调查表、贝克抑郁量表(BDI)和定性访谈评价干预效果.干预前后共脱落653人,故采用符合方案(PP集)和意向性分析(ITT集)比较干预效果.结果:PP集中,干预组干预后的抑郁早期识别关键信息知晓率高于干预前(83.5％ vs.50.5％,P＜0.01),对照组干预前后差异无统计学意义(32.8％ vs.42.6％,P＞0.05);两组的自报抑郁情绪阳性率干预前后差异均无统计学意义(干预组21.8％ vs.13.8％,P＞0.05;对照组31.9％ vs.16.7％,P＞0.05).ITT集中,两组的抑郁早期识别关键知识知晓率干预前后差异均无统计学意义(干预组:46.8％vs.50.6％,P＞0.05;对照组:49.1％ vs.47.1％,P＞0.05);两组的自报抑郁情绪阳性率干预前后均无统计学意义(干预组:25.4％ vs.22.4％,P＞0.05;对照组:33.6％ vs.29.8％,P＞0.05).定性访谈显示,综合心理健康教育可能提高工人的总体心理健康水平.结论:本研究表明,综合心理健康教育能有效提高劳动密集型企业产业工人对抑郁早期识别关键信息的知晓率及总体心理健康水平.     

Self-Transcendence Mediates the Relationship between Early Trauma and Fatal Methods of Suicide Attempts

BackgroundEarly trauma is known to be a risk factor of suicide-related behavior. On the other hand, people who attempt suicide using a fatal method are reported to be more likely to complete suicide. In this study, we assumed that early trauma affects an individual''s temperament and character and thereby increases the risk of a fatal method of suicide attempts.MethodsWe analyzed 92 people with a history of previous suicide attempts. We compared the Temperament and Character Inventory-Revised scores between the groups with and without early trauma, and between the groups with and without a history of suicide attempt using fatal methods through an analysis of covariance with age, sex, and presence of a psychiatric history as covariates. A mediation analysis was conducted of the relationship between early trauma and fatal methods of suicide attempt with self-transcendence as a mediator.ResultsHigher self-transcendence was reported in the fatal group (27.71 ± 13.78 vs. 20.97 ± 12.27, P = 0.010) and the early trauma group (28.05 ± 14.30 vs. 19.43 ± 10.73, P = 0.001), respectively. The mediation model showed that self-transcendence mediates the relationship between early trauma and fatal methods of suicide attempt. The 95% confidence intervals for the direct and indirect effect were (−0.559, 1.390) and (0.026, 0.947), respectively.ConclusionSelf-transcendence may mediate the relationship between early trauma and fatal methods of suicide attempt. Self-transcendence may be associated with unhealthy defenses and suicidal behavior for self-punishment and may constitute a marker of higher suicide risk.     

心理护理在胸痛患者增强检查中的临床效益研究

目的 分析胸痛患者增强检查中增加心理护理措施的临床受益。方法 2019年4～10月收集本院因胸痛行增强检查明确病因的患者123例为观察组,116例患者为对照组。对照组采用常规护理流程,观察组在常规护理基础上增加心理护理措施。比较两组患者前后的状态焦虑量表(State Anxiety inventory,S-AI)得分情况,记录两组患者的人均检查时长、对比剂不良反应发生情况(外渗和过敏反应)、重复穿刺率以及患者满意度。结果 观察组患者自身前后比较S-AI得分差异有显著统计学意义(P0.001)。两组患者采用不同护理措施后比较S-AI得分差异有统计学意义(P0.001)。观察组患者的人均检查时长、重复穿刺率以及对比剂过敏反应发生情况均明显低于对照组,两组患者满意度比较有明显差异(观察组93.50%,对照组72.41%)。结论 胸痛患者增强检查中增加心理护理措施有助于降低患者的紧张焦虑程度,增加患者的配合度,缩短增强检查人均时间,提高患者满意度,为患者安全快速明确病因提供重要保障。     

高年级与低年级医学生批判性思维能力的比较

通过高年级与低年级医学生批判性思维能力差异的比较,探讨目前医学教育对学生批判性思维能力的影响。通过批判性思维能力倾向量表检测暨南大学五年级和一年级临床医学专业学生的批判性思维能力。结果表明五年级和一年级临床医学专业学生批判性思维能力的得分在总体上没有显著性差异(P>0.05),都属于意义不明确批判性思维倾向。进而对批判性思维的7个特性进行比较,即在寻找真相、开放思想、分析能力、系统化能力、自信心、求知欲和认知成熟度方面也没有显著性差异(P>0.05)。在认知成熟度方面,五年级和一年级学生均为正性批判性思维倾向,其余6个方面都属于意义不明确批判性思维倾向。低年级和高年级临床医学专业医学生的批判性思维能力普遍偏弱,在医学教育中应当特别加强学生批判性思维能力的培养。     

Anxious,introverted personality traits in patients with chronic subjective dizziness

Objectives

Chronic subjective dizziness (CSD) is a neurotologic disorder of persistent non-vertiginous dizziness, unsteadiness, and hypersensitivity to one's own motion or exposure to complex visual stimuli. CSD usually follows acute attacks of vertigo or dizziness and is thought to arise from patients' failure to re-establish normal locomotor control strategies after resolution of acute vestibular symptoms. Pre-existing anxiety or anxiety diathesis may be risk factors for CSD. This study tested the hypothesis that patients with CSD are more likely than individuals with other chronic neurotologic illnesses to possess anxious, introverted personality traits.

Methods

Data were abstracted retrospectively from medical records of 40 patients who underwent multidisciplinary neurotology evaluations for chronic dizziness. Twenty-four subjects had CSD. Sixteen had chronic medical conditions other than CSD plus co-existing anxiety disorders. Group differences in demographics, Dizziness Handicap Inventory (DHI) scores, Hospital Anxiety and Depression Scale (HADS) scores, DSM-IV diagnoses, personality traits measured with the NEO Personality Inventory — Revised (NEO-PI-R), and temperaments composed of NEO-PI-R facets were examined.

Results

There were no differences between groups in demographics, mean DHI or HADS-anxiety scores, or DSM-IV diagnoses. The CSD group had higher mean HADS-depression and NEO-PI-R trait anxiety, but lower NEO-PI-R extraversion, warmth, positive emotions, openness to feelings, and trust (all p < 0.05). CSD subjects were significantly more likely than comparison subjects to have a composite temperament of high trait anxiety plus low warmth or excitement seeking.

Conclusion

An anxious, introverted temperament is strongly associated with CSD and may be a risk factor for developing this syndrome.