Personality and anxiety disorders: a review

In this article, we summarize research on how normal personality and personality disorder traits may relate to anxiety disorders as predisposing factors, complications, and results of common underlying etiologies. We outline important questions and how these may be addressed through future research using genetically informative longitudinal and other designs, including: Are high neuroticism/cluster C personality traits causally related to the development of anxiety disorders? To what extent does the state of having an anxiety disorder influence the assessment of personality traits? Do high neuroticism/personality disorder traits and anxiety disorders co-occur because of shared genetic and environmental determinants? And, do personality disorder traits add to the prediction of anxiety disorders when normal personality traits are taken into account?     

The establishment of the department of psychiatry in the Mount Sinai Hospital: a conflict between neurology and psychiatry

A conflict between neurology and psychiatry and controversies about psychoanalysis played an important role in the establishment of psychiatry in the general hospital. This article reviews the impact of this conflict on the establishment of an independent Department of Psychiatry in the Mount Sinai Hospital in New York during the first half of the twentieth century. A unique opportunity is provided to consider the relationships and personalities of the individuals involved, as well as economic, social, and scientific factors, including the introduction of psychoanalysis as a major psychiatric treatment.     

Cognitive difficulties and posttraumatic stress disorder in female victims of intimate partner violence

Subjective cognitive complaints of women exposed to intimate partner violence (IPV) and nonabused women were examined using the Cognitive Difficulties Scale (CDS). Cognitive complaints were compared among victims of IPV with a lifetime diagnosis of posttraumatic stress disorder (PTSD) (PTSD+; n=20), victims of IPV without lifetime PTSD (PTSD-; n=21), and a nonabused comparison group (n=22). The results indicated that both the PTSD+ and PTSD- groups had significantly higher levels of self-perceived cognitive difficulties than nonabused women. Furthermore, PTSD symptom severity was found to be positively correlated with self-perceived cognitive difficulties (r=.47). Further research is needed to determine whether cognitive complaints are associated with exposure to IPV, with the subsequent development of PTSD, or with other not yet understood factors. Furthermore, additional work is needed to resolve whether cognitive complaints are accompanied by objective evidence of cognitive dysfunction in victims of IPV.     

Maternal participant experience in a South African birth cohort study enrolling healthy pregnant women and their infants

Background

Critical to conducting high quality research is the ability to attract and retain participants, especially for longitudinal studies. Understanding participant experiences and motivators or barriers to participating in clinical research is crucial. There are limited data on healthy participant experiences in longitudinal research, particularly in low- and middle-income countries. This study aims to investigate quantitatively participant experiences in a South African birth cohort study.

Methods

Maternal participant experience was evaluated by a self-administered survey in the Drakenstein Child Health Study, a longitudinal birth cohort study investigating the early life determinants of child health. Pregnant mothers, enrolled during the second trimester, were followed through childbirth and the early childhood years. Satisfaction scores were derived from the participant experience survey and quantitatively analyzed; associations between satisfaction scores and sociodemographic variables were then investigated using a linear regression model.

Results

Data were included from 585 pregnant mothers (median age 26.6 years), who had participated in the study for a median time of 16 months. Overall participant satisfaction was high (median score 51/60) and associated with increased attendance of study visits. Reasons for participating were a belief that involvement would improve their health, their child’s health or the health of family and friends. Potential reasons for leaving the study were inconvenience, not receiving clinical or study results, and unexpected changes in study visits or procedures. Variables associated with higher overall satisfaction scores were no prior participation in research, higher socioeconomic status, less intensive follow-up schedules and having experienced stressful life events in the past year.

Conclusions

Satisfaction scores were high and associated with increased visit attendance. Participants’ perceived benefits of study participation, most notably the potential for an improvement in the health of their child, were a significant motivator to enroll and remain in the study. The consistent theme of perceived health benefits as a motivator to join and remain in the study raises the question of whether participation in research results in actual improvements in health.

     

Parent-infant interaction: a growth model approach

The aim of this study is to compare the interaction of fathers and mothers with their 10–12 months old infants (n = 97; parental sensitivity and mood, and infant mood) during five structured contiguous play segments, and to examine the utility of individual growth modeling. Conventional comparison of means across play-segments showed that parents were equally responsive, but mothers were happier than fathers, and infants were equally happy during interaction with both parents. Sensitivity and mood were more strongly related for mothers than for fathers. Uni- and multivariate growth models revealed fine-grained patterns not seen in conventional analysis: (a) parental and infant mood decreased across play more for mothers than for fathers, (b) parental sensitivity in one play-segment predicted parental mood and infant mood in the next segment, (c) change in infants’ mood was related to change in sensitivity in mothers, and to change in mood in fathers, and (d) mothers’ sensitive interaction with the infant was predicted by family socio-demographic background.     

A model of the neural mechanisms underlying multisensory integration in the superior colliculus

Much of the information about multisensory integration is derived from studies of the cat superior colliculus (SC), a midbrain structure involved in orientation behaviors. This integration is apparent in the enhanced responses of SC neurons to cross-modal stimuli, responses that exceed those to any of the modality-specific component stimuli. The simplest model of multisensory integration is one in which the SC neuron simply sums its various sensory inputs. However, a number of empirical findings reveal the inadequacy of such a model; for example, the finding that deactivation of cortico-collicular inputs eliminates the enhanced response to a cross-modal stimulus without eliminating responses to the modality-specific component stimuli. These and other empirical findings inform a computational model that accounts for all of the most fundamental aspects of SC multisensory integration. The model is presented in two forms: an algebraic form that conveys the essential insights, and a compartmental form that represents the neuronal computations in a more biologically realistic way.     

Multisensory-mediated auditory localization

Multisensory integration is a powerful mechanism for maximizing sensitivity to sensory events. We examined its effects on auditory localization in healthy human subjects. The specific objective was to test whether the relative intensity and location of a seemingly irrelevant visual stimulus would influence auditory localization in accordance with the inverse effectiveness and spatial rules of multisensory integration that have been developed from neurophysiological studies with animals [Stein and Meredith, 1993 The Merging of the Senses (Cambridge, MA: MIT Press)]. Subjects were asked to localize a sound in one condition in which a neutral visual stimulus was either above threshold (supra-threshold) or at threshold. In both cases the spatial disparity of the visual and auditory stimuli was systematically varied. The results reveal that stimulus salience is a critical factor in determining the effect of a neutral visual cue on auditory localization. Visual bias and, hence, perceptual translocation of the auditory stimulus appeared when the visual stimulus was supra-threshold, regardless of its location. However, this was not the case when the visual stimulus was at threshold. In this case, the influence of the visual cue was apparent only when the two cues were spatially coincident and resulted in an enhancement of stimulus localization. These data suggest that the brain uses multiple strategies to integrate multisensory information.     

Borderline pathology and the Personality Assessment Inventory (PAI): an evaluation of criterion and concurrent validity

In this study, we examined how patients diagnosed with borderline pathology (BP) would respond on the Personality Assessment Inventory (PAI; Morey, 1991) Borderline (BOR) scales in relation to patients without BP pathology. In addition, we examined whether the PAI BOR scales would be related to variables on the Social Cognition and Object Relations Scale (SCORS; Hilsenroth, Stein, & Pinsker, 2004; Westen, 1995) derived from early memory narratives. Results indicate that outpatients with a Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnosis of BP scored significantly higher on the PAI BOR Total (BOR-Total) score, Identity Problems, and Self- Harm scales in comparison to a Non-BP clinical sample. The overall correct classification rate for the presence or absence of BP using the BOR Total scale (T >or= 70) was 73%. In addition, there were several significant relationships between dimensional PAI BOR scales and the presence versus absence of DSM-IV BP. Moreover, both the BOR-Total and Affect Instability scales were significantly related to the SCORS variable Complexity of Representations. We provide clinical examples to illustrate these research findings in an applied manner.     

Fatigue, cognitive functioning and psychological distress in Marfan syndrome, a pilot study

Marfan patients report fatigue as a major subjective complaint. We found no studies exploring the subject. The aim of this study was in a strictly defined Marfan population to assess self-reported fatigue, cognitive functions and psychological distress, correlations among them and correlations to visual acuity, joint hypermobility and use of beta-blockers. Sixteen subjects aged 18 - 30 years, fulfilling the Gent criteria, were assessed with the Fatigue Severity Scale, Fatigue Questionnaire, a comprehensive battery of neuropsychological tests and the General Health Questionnaire (GHQ). Self-reported fatigue was comparable with fatigue reported in other severe chronic diseases and disabilities, and was primarily in the mental/psychological domain. Psychological distress was higher than expected compared with the population at large. All neuropsychological test results were within the normal range, except for tests of visuo-motor coordination and speed of information processing. There was a significant inverse correlation between Fatigue Questionnaire ratings and some neuropsychological tests. Fatigue seems to be a serious problem for persons with Marfan syndrome and seems related to some areas of cognitive functioning. We found no overall impairment in cognitive functioning, but slightly reduced speed of information processing. Reduced visuo-motor coordination could be explained by impaired visual acuity.