Internalizing and externalizing behavior in adult ADHD

Although there are many studies available investigating internalizing and externalizing behavior in childhood and adolescent manifestations of attention-deficit/hyperactivity disorder, there is limited information about their relevance in adults featuring persistence of the disease. We examined a large sample of 910 adults affected with attention-deficit/hyperactivity disorders (AADHD) for internalizing and externalizing behavior. Regarding correlates of internalizing behavior, AADHD probands showed significantly higher scores of the anxiety- and depression-related personality traits Neuroticism and Harm Avoidance, compared with reference values. The lifetime comorbidity of depressive disorders, anxiety disorders, and anxious or fearful Cluster C personality disorders (PDs) is elevated in AADHD patients compared with general population. Regarding correlates of externalizing behavior, patients affected with AADHD show significantly lower scores of Conscientiousness and significantly higher scores of Novelty Seeking than the published German reference values. Emotional, dramatic, or erratic Cluster B PDs were most frequent in AADHD. Internalizing and externalizing behavior notably affected psychosocial status to a similar extent. The frequency of both internalizing and externalizing behavior in AADHD might reflect an underlying emotional regulation disorder.     

How Different Medical School Selection Processes Call upon Different Personality Characteristics

Background

Research indicates that certain personality traits relate to performance in the medical profession. Yet, personality testing during selection seems ineffective. In this study, we examine the extent to which different medical school selection processes call upon desirable personality characteristics in applicants.

Methods

1019 of all 1055 students who entered the Dutch Bachelor of Medicine at University of Groningen, the Netherlands in 2009, 2010 and 2011 were included in this study. Students were admitted based on either top pre-university grades (n = 139), acceptance in a voluntary multifaceted selection process (n = 286), or lottery weighted for pre-university GPA. Within the lottery group, we distinguished between students who had not participated (n = 284) and students who were initially rejected (n = 310) in the voluntary selection process. Two months after admission, personality was assessed with the NEO-FFI, a measure of the five factor model of personality. We performed ANCOVA modelling with gender as a covariate to examine personality differences between the four groups.

Results

The multifaceted selection group scored higher on extraversion than all other groups(p<0.01), higher on conscientiousness than both lottery-admitted groups(p<0.01), and lower on neuroticism than the lottery-admitted group that had not participated in the voluntary selection process. The latter group scored lower on conscientiousness than all other groups(p<0.05) and lower on agreeableness than the multifaceted selection group and the top pre-university group(p<0.01).

Conclusions

Differences between the four admission groups, though statistically significant, were relatively small. Personality scores in the group admitted through the voluntary multifaceted selection process seemed most fit for the medical profession. Personality scores in the lottery-admitted group that had not participated in this process seemed least fit for the medical profession. It seems that in order to select applicants with suitable personalities, an admission process that calls upon desirable personality characteristics is beneficial.     

Psychometric comparison of students in medicine and other faculties: social factors and psychologic symptoms

Few studies have investigated personality and psychopathological profiles associated to the choice of university education. Our study examined students from four faculties of Turin University, in Turin, Italy (Medicine, Engineering, Education, Law), comparing sociodemographic features, personality characteristics and psychiatric symptoms. A heterogeneous group of 1,323 students were assessed using a semistructured interview, the Personality Diagnostic Questionnaire-Revised (PDQ-R), and the Symptoms Checklist 90 (SCL-90). Statistical analysis included four logistic regression models, each fitted for one faculty, considering the other three as a control group. Associations were found in Medical and Engineering students concerning type of high school, school final score, and father?s socioeducational level. Factors associated with students of Law and Education included socioeducational characteristics, but stronger correlations were seen with PDQ-R personality scales and SCL-90 symptom clusters. In conclusion, four different profiles were identified. Medicine was not significantly related to personality and psychiatric factors. Engineering was related to male gender, choice of technical high school and father?s social level. Law was related to female gender and narcissistic personality profile. These data may be useful for counseling activities addressed to high school and university students.     

Risk Acceptance in Multiple Sclerosis Patients on Natalizumab Treatment

Objective

We aimed to investigate the ability of natalizumab (NTZ)-treated patients to assume treatment-associated risks and the factors involved in such risk acceptance.

Methods

From a total of 185 patients, 114 patients on NTZ as of July 2011 carried out a comprehensive survey. We obtained disease severity perception scores, personality traits’ scores, and risk-acceptance scores (RAS) so that higher RAS indicated higher risk acceptance. We recorded JC virus status (JCV+/-), prior immunosuppression, NTZ treatment duration, and clinical characteristics. NTZ patients were split into subgroups (A-E), depending on their individual PML risk. Some 22 MS patients on first-line drugs (DMD) acted as controls.

Results

No differences between treatment groups were observed in disease severity perception and personality traits. RAS were higher in NTZ than in DMD patients (p<0.01). Perception of the own disease as a more severe condition tended to predict higher RAS (p=0.07). Higher neuroticism scores predicted higher RAS in the NTZ group as a whole (p=0.04), and in high PML-risk subgroups (A-B) (p=0.02). In low PML-risk subgroups (C-E), higher RAS were associated with a JCV+ status (p=0.01). Neither disability scores nor pre-treatment relapse rate predicted RAS in either group.

Conclusions

Risk acceptance is a multifactorial phenomenon, which might be partly explained by an adaptive process, in light of the higher risk acceptance amongst NTZ-treated patients and, especially, amongst those who are JCV seropositive but still have low PML risk, but which seems also intimately related to personality traits.     

Genetic variation in the hypothalamic-pituitary-adrenocortical axis regulatory factor, T-box 19, and the angry/hostility personality trait

Neurotic personality traits are important factors in several psychiatric disorders and suicidal behavior. Here, we have investigated the existence of potential relationships between neurotic personality traits and genetic variation. Non-suicidal parents derived from trios (suicide attempter and both parents) and non-suicidal volunteers, examined by the Neuroticism, Extraversion and Openness (NEO) Personality Inventory - Revised (NEO PI-R), were divided into screening and replication samples. The screening sample (n= 127) was used to select potential relationships between neurotic personality traits and genetic variation among 130 single nucleotide polymorphisms (SNPs). Screening (analysis of variance) with regard to the personality dimension neuroticism indicated potential relationships at three different loci. More detailed analysis of these three SNPs at NEO PI-R facet level indicated four potential relationships. T-test analysis in the replication sample (n= 617) was used to retest the relationships indicated during screening. One of those relationships was confirmed in the replication sample (P= 0.0052; Bonferroni correction), indicating that genetic variation at the human T-box 19 (TBX19) locus is related to the personality trait angry/hostility. Furthermore, using analysis of haplotypes among trios by transmission disequilibrium test and its extension, the family-based association test, overtransmission of a haplotype GAC at the TBX19 locus was associated with increased angry/hostility scores among suicide attempters (P= 0.009; Bonferroni correction). This is to our knowledge the first report on the association of the angry hostility personality trait with genetic variation at the TBX19 locus, an important regulator of the hypothalamic-pituitary-adrenocortical axis.     

Two shades of boldness: novel object and anti-predator behavior reflect different personality dimensions in domestic rabbits

It is increasingly common to quantify and describe behavioral variation in domestic and wild animals in terms of “personality”. Correlating behavioral traits are referred to as personality “dimensions” or “factors” and different dimensions have been reported in different species. “Boldness” is a well-described personality dimension in several species, although some issues remain unclear. Previous models of boldness include both novelty and risk taking, but recent studies indicate that these types of behaviors may reflect separate personality dimensions. In this study, we developed a behavioral test battery for domestic rabbits, and recorded behaviors of 61 individuals in four different situations (novel object, novel arena, social, and predator interactions). We used domestic rabbits as a model because behavioral variation in rabbits has rarely been quantified in terms of personality dimensions, although rabbit behavior is described. We also wanted to investigate behavioral variation in a Swedish rabbit breed of conservation concern — the Gotland rabbit. Factor analysis of the behavioral test measures suggested three personality dimensions: “exploration”, “boldness”, and “anxiety”. Novel object scores clustered in the exploration and boldness factors, whereas scores associated with predator interactions were explained by “anxiety”, indicating that novel object and anti-predator behavior reflect different personality dimensions in rabbits.     

Concerns Expressed by Parents of Children with Pervasive Developmental Disorders for Different Time Periods of the Day: A Case–Control Study

Background/Aim

The Questionnaire: Children with Difficulties (QCD) is a parent-assessed questionnaire designed to evaluate child’s difficulties in functioning during specific periods of the day. This study aimed to evaluate difficulties in daily functioning of children and adolescents with pervasive developmental disorder (PDD) using the QCD. Results were compared with those for a community sample.

Methods

A case–control design was used. The cases comprised elementary school students (182 males, 51 females) and junior high school students (100 males, 39 females) with PDD, whereas a community sample of elementary school students (568 males, 579 females) and junior high school students (180 males, 183 females) was enrolled as controls. Their behavior was assessed using the QCD, the Tokyo Autistic Behavior Scale (TABS), the ADHD-rating scale (ADHD-RS), and the Oppositional Defiant Behavior Inventory (ODBI) for elementary and junior high school students, respectively. Effects of gender and diagnosis on the QCD scores were analyzed. Correlation coefficients between QCD and TABS, ADHD-RS, and ODBI scores were analyzed.

Results

The QCD scores for the children with PDD were significantly lower compared with those from the community sample (P < 0.001). Significantly strong correlations were observed in more areas of the ADHD-RS and ODBI scores compared with the TABS scores.

Conclusions

Children with PDD experienced greater difficulties in completing basic daily activities; moreover, their QCD scores revealed stronger associations with their ADHD-RS and ODBI scores in comparison with their TABS scores. The difficulties of PDD, ADHD and OBDI symptoms combined in children makes it necessary to assess all diagnoses before any therapy for PDD is initiated in order to be able to evaluate its results properly.     

The relationship between violent video games,acculturation, and aggression among Latino adolescents

Multiple factors are involved in the occurrence of aggressive behavior. The purpose of this study was to evaluate the hypotheses that Latino middle school children exposed to higher levels of video game playing will exhibit a higher level of aggression and fighting compared to children exposed to lower levels and that the more acculturated middle school Latino children will play more video games and will prefer more violent video games compared to less acculturated middle school Latino children. This study involved 5,831 students attending eight public schools in Texas. A linear relationship was observed between the time spent playing video games and aggression scores. Higher aggression scores were significantly associated with heavier video playing for boys and girls (p < 0.0001). The more students played video games, the more they fought at school (p < 0.0001). As Latino middle school students were more acculturated, their preference for violent video game playing increased, as well as the amount of time they played video games. Students who reported speaking more Spanish at home and with their friends were less likely to spend large amounts of time playing video games and less likely to prefer violent video games (p < 0.05).     

Influence of personality disorder on the treatment of panic disorder--comparison study

Most clinicians tend to believe that the occurrence of the anxiety disorder in comorbidity with a personality disorder often leads to longer treatment, worsens the prognosis, and thus increasing treatment costs. The study is designed to compare the short-term effectiveness of combination of cognitive behavioral therapy and pharmacotherapy in patient suffering with panic disorder with and without personality disorder. METHOD: We compare the efficacy of 6th week therapeutic program and 6th week follow up in patients suffering with panic disorder and/or agoraphobia and comorbid personality disorder (29 patients) and panic disorder and/or agoraphobia without comorbid personality disorder (31 patients). Diagnosis was done according to the ICD-10 research diagnostic criteria confirmed with MINI and support with psychological methods: IPDE, MCMI-III and TCI. Patients were treated with CBT and psychopharmacs. They were regularly assessed in week 0, 2, 4, 6 and 12 by an independent reviewer on the CGI (Clinical Global Improvement) for severity and change, PDSS (Panic Disorder Severity Scale), HAMA (Hamilton Anxiety Rating Scale), SDS (Sheehan Disability Scale), HDRS (Hamilton Depression Rating Scale), and in self-assessments BAI (Beck Anxiety Inventory) and BDI (Beck Depression Inventory). RESULTS: A combination of CBT and pharmacotherapy proved to be the effective treatment of patients suffering with panic disorder and/or agoraphobia with or without comorbid personality disorder. The 12th week treatment efficacy in the patients with panic disorder without personality disorder had been showed significantly better compared with the group with panic disorder comorbid with personality disorder in CGI and specific inventory for panic disorder--PDSS. Also the scores in depression inventories HDRS and BDI showed significantly higher decrease during the treatment comparing with group without personality disorder. But the treatment effect between groups did not differ in objective anxiety scale HAMA, and subjective anxiety scale BAI.     

Response of patients to upper gastrointestinal endoscopy: effect of inherent personality traits and premedication with diazepam.

The influence of personality traits on the reaction of patients to upper gastrointestinal endoscopy was studied prospectively in 86 patients. High N (neuroticism) scores on the Eysenck personality inventory were associated with poor tolerance to and future compliance with the procedure. Although premedication with diazepam did not affect the degree of discomfort and distress during the procedure, it guaranteed acceptance of repeat endoscopy by virtue of its strong amnesic effect. By contrast, not giving premedication to patients who were anxious and had high N scores jeopardized future compliance. These findings suggest that a version of the Eysenck personality inventory should be used to assess patients'' neurotic phenotype and their need for premedication before endoscopy. Alternatively, all patients might be given premedication.     

经颅多普勒超声对脑血管状态与人格特征相关性研究

目的：研究脑血管状态与人格特征的相关性。方法：人格特征应用A 型行为类型量表、艾森克人格问卷（EPQ）对60 名20-35岁青年人群进行问卷调查,并划分出不同类型;脑血管状态应用经颅多普勒超声（TCD）的诊断技术测查60 人的大脑中动脉（MCV）的血流速度来判断脑血管的紧张程度。结果：脑血管紧张组：A 型人格为19 人占59.3%,对照组：A 型人格为3 人占10.7%,以A 型人格占优势（x2 =22.85,P〈0.01）。脑血管紧张组（36.2± 5.8）A 型行为问卷平均得分高于对照组（20.3± 2.4））（t=6.81,P〈0.01）。脑血管紧张组P分、N 分、L分与正常对照组比较,差异无统计学意义（均P＞0.05）;脑血管紧张组E分（内外向）高于对照组,差异有统计学意义（P＜0.05）。四种性格类型相比,外向情绪不稳定型的脑血管紧张组13（40.6%）与对照组4（14.3%）相比所占比例较高（x2 =21.91, P〈0.05）。结论：A 型人格,外向不稳定的人格特征与脑血流速度增快有关,可能是脑血管紧张的诱发因素之一。     

Predicting Risk-Taking Behavior from Prefrontal Resting-State Activity and Personality

Risk-taking is subject to considerable individual differences. In the current study, we tested whether resting-state activity in the prefrontal cortex and trait sensitivity to reward and punishment can help predict risk-taking behavior. Prefrontal activity at rest was assessed in seventy healthy volunteers using electroencephalography, and compared to their choice behavior on an economic risk-taking task. The Behavioral Inhibition System/Behavioral Activation System scale was used to measure participants’ trait sensitivity to reward and punishment. Our results confirmed both prefrontal resting-state activity and personality traits as sources of individual differences in risk-taking behavior. Right-left asymmetry in prefrontal activity and scores on the Behavioral Inhibition System scale, reflecting trait sensitivity to punishment, were correlated with the level of risk-taking on the task. We further discovered that scores on the Behavioral Inhibition System scale modulated the relationship between asymmetry in prefrontal resting-state activity and risk-taking. The results of this study demonstrate that heterogeneity in risk-taking behavior can be traced back to differences in the basic physiology of decision-makers’ brains, and suggest that baseline prefrontal activity and personality traits might interplay in guiding risk-taking behavior.     

Prosocial Behaviors during School Activities among Child Survivors after the 2011 Earthquake and Tsunami in Japan: A Retrospective Observational Study

Background

The 2011 Japan massive tsunami traumatized many children. The aim of this study was to assess changes in strengths and difficulties experienced in home and school by among surviving children after the 2011 tsunami, in comparison with published normal Japanese data.

Methods

In November 2012 (20 months after the disaster) and September 2013 (30 months after the disaster), the Strengths and Difficulties Questionnaire (SDQ), a questionnaire on children''s strengths and difficulties in home and school activities, were distributed to 12,193 and 11,819 children, respectively. An effective response of children 20 months and 30 month after the disaster was obtained in 10,597 children (86.9%), and 10,812 children (91.4%), respectively. The SDQ scores evaluated by parents and teachers were compared with published normal Japanese SDQ scores.

Results

The SDQ scores (emotional problems, conduct problems, hyperactivity/inattention, peer relationship problems, and total difficulty score) evaluated by parents of children in the 4th to 9th grade who were evaluated after 30 and 20 months were significantly high compared with the published normal data of children without traumatic experiences (all P<0.001). The SDQ scores (prosocial behavior) evaluated by teachers of children in the 4th to 9th grade who were evaluated after 30 and 20 months were significantly low compared with the published normal data of children without traumatic experiences (all P<0.001).

Conclusions

This study showed that the experience of the disaster affected those children with prosocial behaviors towards teachers and friends at school. However, no significant changes (in their prosocial attitude) had been seen at home, where they continued to keep their respect and caring feelings for parents. These results indicate that for accurate diagnosis, clinicians should not only evaluate these children''s daily activities at home but also try to objectively assess their daily activities at school.     

A followup study of the academic attainment and classroom behavior of children with elevated dentine lead levels

To investigate the impact of low-level lead exposure on children's behavior within a natural setting, we assessed the school performance of a sample of 141 elementary school children classified according to dentine lead level. Twenty-two children had “elevated” levels (≥20 parts per million), 71 had “midrange” levels (10.0–19.9 parts per million), and 48 had “low” levels (<10 parts per million). Four types of outcome data were collected: (1) scores on a standardized group intelligence test, (2) teachers' ratings, (3) incidence of academic failure (assignment to remedial aid, grade retention), and (4) observations of classroom behavior. In general, higher dentine lead levels were associated with less favorable school performance, with most covariance-adjustedp-values in the range of 0.05–0.15. The incidence of grade retention was the outcome most strongly related to lead level. The pattern of results suggests a consistent, though weak relationship between children's dentine lead levels and elementary school performance.     

Temporal stability of personality traits in group-housed gestating sows

The movement of sows (Sus scrofa domesticus) out of individual gestation stalls and into group housing can introduce new sources of stress due to the enhanced environmental and social complexity. Some sows may have the behavioral capacity to adapt to these changes better than others. However, little is known about individual differences in behavioral responses, or personality traits, in gestating sows and how they impact the animal’s ability to cope with group housing. The temporal consistency in the assessment of an animal’s behavior is a prerequisite to the establishment of personality traits and was addressed at an interval of approximately five months during two consecutive gestation periods in the present study. Forty-six group-housed sows from a commercially available genetic line were assessed for aggressive and social behaviors at mixing into a group, reaction to human approach, ease of handling, exploration of an open field, and reaction to a novel object. Principal component analysis revealed the presence of three traits accounting for over 60% of the variance in behaviors: aggressive/dominant, avoidant of humans and active/exploratory. Individual component scores were significantly correlated between pregnancies demonstrating temporal stability of trait assessment. Significant relationships were found between aggressive/dominant component scores and individual feed rank at electronic sow feeding stations and skin lesion scores, as well as between avoidant of humans component scores and average number of stillbirths per litter. These findings provide evidence for the temporal stability of distinct behaviors contributing to personality traits within a group of genetically similar sows and demonstrate how these traits may be useful in identifying individuals likely to succeed in group housing.     

Psychometric analysis of behavior pattern A in the Spanish population and its relationship with personality variables

As a first step in the epidemiological study for CHD prevention among the Spanish population, the authors have analyzed two of the instruments for the assessment of the behavior pattern A (JAS and Bortner questionnaires). From a student sample (n = 302), a factor analysis of items and scales was made, relating pattern A scores to Eysenck's personality variables (EPQ). The importance of an accurate psychometric study of pattern A was emphasized, in order to select A subjects as specifically as possible.     

The influence of personality traits on reported adherence to medication in individuals with chronic disease: an epidemiological study in West Sweden

Background

Limited research exists exploring the influence of personality on adherence behaviour. Since non-adherence is a major obstacle in treating prevalent chronic diseases the aim was to determine whether personality traits are related to reported adherence to medication in individuals with chronic disease.

Methodology/Principal Findings

Individuals with chronic disease (n = 749) were identified in a random population sample of 5000 inhabitants aged 30–70 in two municipalities in West Sweden. Data on five personality traits, Neuroticism, Extraversion, Openness to experiences, Agreeableness, and Conscientiousness, and medication adherence behaviour was collected by questionnaires. Statistical analyses resulted in a negative relationship between Neuroticism and medication adherence (P<0.001), while both Agreeableness (P<0.001) and Conscientiousness (P<0.001) were positively related to adherence. At high levels of Conscientiousness, low adherence was related to higher scores in Neuroticism. At high levels of Agreeableness, low adherence was related to low scores in Conscientiousness and high scores in Openness to experiences.

Conclusions

This study demonstrated that multiple personality traits are of significant importance for adherence behaviour in individuals with chronic disease. The findings suggest that several personality traits may interact in influencing adherence behaviour. Personality traits could putatively be used to focus efforts to educate and support patients with high risk of low medical adherence.     

Fats and factors: lipid profiles associate with personality factors and suicidal history in bipolar subjects

Polyunsaturated fatty acids (PUFA) have shown efficacy in the treatment of bipolar disorder, however their specific role in treating the illness is unclear. Serum PUFA and dietary intakes of PUFA associate with suicidal behavior in epidemiological studies. The objective of this study was to assess serum n-3 and n-6 PUFA levels in bipolar subjects and determine possible associations with suicidal risk, including suicidal history and relevant personality factors that have been associated with suicidality. We studied 27 bipolar subjects using the NEO-PI to assess the big five personality factors, structured interviews to verify diagnosis and assess suicidal history, and lipomics to quantify n-3 and n-6 PUFA in serum. We found positive associations between personality factors and ratios of n-3 PUFA, suggesting that conversion of short chain to long chain n-3s and the activity of enzymes in this pathway may associate with measures of personality. Thus, ratios of docosahexaenoic acid (DHA) to alpha linolenic acid (ALA) and the activity of fatty acid desaturase 2 (FADS2) involved in the conversion of ALA to DHA were positively associated with openness factor scores. Ratios of eicosapentaenoic acid (EPA) to ALA and ratios of EPA to DHA were positively associated with agreeableness factor scores. Finally, serum concentrations of the n-6, arachidonic acid (AA), were significantly lower in subjects with a history of suicide attempt compared to non-attempters. The data suggest that specific lipid profiles, which are controlled by an interaction between diet and genetics, correlate with suicidal history and personality factors related to suicidal risk. This study provides preliminary data for future studies to determine whether manipulation of PUFA profiles (through diet or supplementation) can affect personality measures and disease outcome in bipolar subjects and supports the need for further investigations into individualized specific modulations of lipid profiles to add adjunctive value to treatment paradigms.     

The Relationship between Personality Dimensions and Resiliency to Environmental Stress in Orange-Winged Amazon Parrots (Amazona amazonica), as Indicated by the Development of Abnormal Behaviors

Parrots are popular companion animals, but are frequently relinquished because of behavioral problems, including abnormal repetitive behaviors like feather damaging behavior and stereotypy. In addition to contributing to pet relinquishment, these behaviors are important as potential indicators of diminished psychological well-being. While abnormal behaviors are common in captive animals, their presence and/or severity varies between animals of the same species that are experiencing the same environmental conditions. Personality differences could contribute to this observed individual variation, as they are known risk factors for stress sensitivity and affective disorders in humans. The goal of this study was to assess the relationship between personality and the development and severity of abnormal behaviors in captive-bred orange-winged Amazon parrots (Amazona amazonica). We monitored between-individual behavioral differences in enrichment-reared parrots of known personality types before, during, and after enrichment deprivation. We predicted that parrots with higher scores for neurotic-like personality traits would be more susceptible to enrichment deprivation and develop more abnormal behaviors. Our results partially supported this hypothesis, but also showed that distinct personality dimensions were related to different forms of abnormal behavior. While neuroticism-like traits were linked to feather damaging behavior, extraversion-like traits were negatively related to stereotypic behavior. More extraverted birds showed resiliency to environmental stress, developing fewer stereotypies during enrichment deprivation and showing lower levels of these behaviors following re-enrichment. Our data, together with the results of the few studies conducted on other species, suggest that, as in humans, certain personality types render individual animals more susceptible or resilient to environmental stress. Further, this susceptibility/resiliency can have a long-term effect on behavior, as evidenced by behavioral changes that persisted despite re-enrichment. Ours is the first study evaluating the relationship between personality dimensions, environment, and abnormal behaviors in an avian species.