Search

We examined the link between parent proneness to shame and two forms of psychological control, overprotection and critical/rejecting behavior, in parents of preschoolers. Because shame is self-condemning, proneness to shame affects intrapersonal and interpersonal functioning. We hypothesized that parents' emotion-regulatory responses to shame would increase the likelihood of psychological control: anxiety by leading to overprotection mediated by a worrisome approach to the child, and anger/hostility by leading to critical/rejecting parenting mediated by negative reactivity to the child. Participants were 198 mother-father pairs with a child 3.6 to 4.5 years of age. Overprotective and critical/rejecting parenting were assessed using both self and spouse reports of parenting practices. In addition, parents completed measures of proneness to shame, worrisome overconcern about the child, and negative reactivity to the child. Structural equation modeling yielded results that supported mediation by negative approach to the child for mothers' and fathers' critical/rejecting behavior. For fathers but not mothers, shame was indirectly associated with overprotective parenting through worrisome approach to the child. Parents' proneness to shame may be an important factor leading to the use of psychological control.

Three important psychological dimensions in the suicide literature (neuroticism, self-criticism, and hopelessness) were examined in relation to suicidal ideation and attempts in the U.S. National Comorbidity Survey (Kessler et al., 1994; n = 5,877), after first controlling for the effects of previously identified sociodemographic and psychiatric variables related to suicidality in this nationally representative sample (Kessler, Borges, & Walters, 1999). Analyses were conducted separately for lifetime, current (12-month), and past history of suicidal ideation and attempts. Brief indices of self-criticism and hopelessness were robustly associated with suicide attempts across all three time frames. The results support the value of examining psychological individual differences over sociodemographic and psychiatric diagnoses alone in the comprehensive assessment of factors associated with suicidality in the general population.

Three important psychological dimensions in the suicide literature (neuroticism, self-criticism, and hopelessness) were examined in relation to suicidal ideation and attempts in the U.S. National Comorbidity Survey (Kessler et al., 1994; n = 5,877), after first controlling for the effects of previously identified sociodemographic and psychiatric variables related to suicidality in this nationally representative sample (Kessler, Borges, & Walters, 1999). Analyses were conducted separately for lifetime, current (12-month), and past history of suicidal ideation and attempts. Brief indices of self-criticism and hopelessness were robustly associated with suicide attempts across all three time frames. The results support the value of examining psychological individual differences over sociodemographic and psychiatric diagnoses alone in the comprehensive assessment of factors associated with suicidality in the general population.

The Wechsler Adult Intelligence Scale-3rd Edition (WAIS-III) was released in 1997. Short farms developed for previous versions have not yet been investigated for the WAIS-III in special populations. A 4-subtest [...]

Background & Aims: Cross-sectional studies have identified high levels of fatigue in patients with active or quiescent inflammatory bowel disease (IBD), but there has been little attention to the long-term effects of fatigue in these patients. We performed a longitudinal study of fatigue in patients with IBD to determine its course and contributing factors. Methods: Data were obtained from participants in the Manitoba IBD Cohort Study (N = 312; 51% with Crohn's disease), a longitudinal population-based study. Symptomatic disease activity was measured every 6 months for 2 years to characterize long-term disease patterns as active, fluctuating, or inactive, based on the validated Manitoba IBD Index. We collected data concurrently on fatigue (Multidimensional Fatigue Inventory), psychological function, and laboratory biomarkers at the point of study entry and 1 and 2 years later. Results: Of the study participants, 26% had consistently inactive, 29% had fluctuating, and 45% had consistently active disease over the 2-year time period. Mean levels of fatigue were strongly associated with disease activity; participants with consistently inactive disease had the lowest level of fatigue at each time point. Multivariate analyses indicated fatigue levels increased over time regardless of disease pattern (P < .001). Adjusting for disease activity, disease type and age, sex (female; P < .001), and psychological variables of distress (P < .001), reduced psychological well-being (P = .002) and poor sleep quality (P < .001) were associated independently with increases in fatigue over time. Conclusions: Fatigue can increase over time in patients with IBD, even when their disease is in remission. Psychological factors are useful targets for intervention to reduce fatigue. [Copyright &y& Elsevier]

Individual personality disorders (PD) are grouped into three clusters in the DSM-IV (A, B, and C). There is very little empirical evidence available concerning the validity of this model in the general population. The current study included all 10 of the DSM-IV PD assessed in Wave 1 and Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Confirmatory factor analysis was used to evaluate three plausible models of the structure of Axis II personality disorders (the current hierarchical DSM-IV three-factor model in which individual PD are believed to load on their assigned clusters, which in turn load onto a single Axis II factor; a general single-factor model; and three independent factors). Each of these models was tested in both the total and also separately for gender. The higher order DSM-IV model demonstrated good fit to the data on a number of goodness-of-fit indices. The results for this model were very similar across genders. A model of PD based on the current DSM-IV hierarchical conceptualization of a higher order classification scheme received strong empirical support through confirmatory factor analysis using a number of goodness-of-fit indices in a nationally representative sample. Other models involving broad, higher order personality domains such as neuroticism in relation to personality disorders have yet to be tested in epidemiologic surveys and represent an important avenue for future research. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The purpose of this hypothesis-generating study was to determine whether personality domains and specific personality traits are uniquely associated with sleep duration using data obtained from the National Comorbidity Survey (NCS). Methods: Using trained interviewers, we administered to the 5877 noninstitutionalized adults living in the United States the Composite International Diagnostic Interview (World Health Organization. Composite International Diagnostic Interview. Geneva, Switzerland: WHO, 1990) to assess for any DSM-III-R psychiatric diagnoses, and they completed self-report measures of personality and sleep. This was a secondary data analysis using information from a large existing public use data set (NCS-part II). The NCS-part II was an epidemiologic survey based on a stratified multistage area probability method with a response rate of 82.4%. Results: Using a multivariate logistic regression technique, we found significant and positive associations between short sleep (defined as ≤6 hours of sleep per 24-hour period) and self-criticism (odds ratio [OR] = 1.36), the presence of a medical condition (OR = 1.35), neuroticism (OR = 1.30), and the use of sedating medication in the past 12 months (OR = 1.26). Significant and positive associations were found for long sleep (defined as ≥9 hours per 24 hour period) and a diagnosis of dysthymia (OR = 1.52), the use of a sedating medication in the past 12 months (OR = 1.52), emotional reliance on another person (OR = 1.37), employment status (OR = 1.31), and marital status (OR = 1.20). Conclusions: Findings suggest that personality, even after controlling for psychiatric and medical conditions, is associated with sleep length and may be an additional factor to consider when assessing any individual patient. [Copyright &y& Elsevier]

Background & Aims: We aimed to assess the relationship of disease type and disease activity with psychological functioning and quality of life (QOL) in a population-based cohort of patients with recently diagnosed inflammatory bowel disease (IBD). Methods: A total of 388 individuals diagnosed within 7 years were recruited from a population-based registry of IBD patients for the Manitoba IBD Cohort Study. Participants completed a clinical interview and standardized self-report measures of positive and negative psychological functioning, and QOL. Disease activity was determined by symptom self-report over the prior 6 months; Harvey–Bradshaw or Powell–Tuck disease activity indices also were used. Disease type was determined through chart verification. Results: Seventy-four percent of Crohn’s disease and 66% of ulcerative colitis participants had active disease during the previous 6 months. Multivariate regression showed that those with active disease had higher levels of distress, health anxiety, and perceived stress, lower social support, well-being and mastery, and poorer disease-specific QOL, relative to those with inactive disease. Disease type was not contributory to psychological functioning or QOL. Pain anxiety (fear of pain) and pain-specific catastrophizing were not associated with disease activity, after controlling for other psychological variables. Participants with either active or inactive disease had suboptimal general QOL. Conclusions: Ulcerative colitis and Crohn’s disease participants were not differentiated in their psychological profiles. Given the strong association between disease-specific QOL, psychological functioning, and disease activity, it is important to be aware of related difficulties in patients with active IBD. There is a continued impact on QOL by the disease, even when it is inactive. [Copyright &y& Elsevier]

Background & Aims: The Manitoba Inflammatory Bowel Disease (IBD) Cohort Study is a population-based prospective cohort study of recently diagnosed IBD (n = 396). At enrollment, 162 (41%) indicated gastrointestinal symptom ≥3 years before diagnosis. We aimed to determine whether coexistence of irritable bowel syndrome (IBS) had a role in symptoms before IBD diagnosis. Methods: Patients were interviewed about symptoms and investigations before IBD diagnosis. Patients were assessed retrospectively for preexisting IBS. Results: Of 112 patients interviewed, 58% had Crohn’s disease, 37% UC, 3% proctitis, and 2% indeterminant colitis. Symptoms at IBD diagnosis were considered the same (7%), worse (43%), different (20%), or both worse and different (30%) than at initial onset. Mean time between initial symptoms and diagnosis was 11 years (range, 3–48 years). Increasing age at IBD diagnosis correlated with a longer period after initial symptoms and diagnosis of IBD (r = .32, P < .0001). Gender and specific IBD diagnosis had no effect on this time period. Patients were identified as no previous IBS (51%), likely IBS (25%), and possible IBS (24%). Those with likely and possible IBS had a trend toward longer symptom duration before IBD diagnosis than those without IBS (P = .07). Of the total IBD cohort (n = 396), considering only those with symptoms for ≥3 years before diagnosis, 14% were considered to have likely or possible IBS. Conclusions: These data suggest that older patients and those with likely and possible preexisting IBS are more likely to experience longer symptom duration before diagnosis of IBD. The prevalence rate of IBS was similar to estimated base rates in the general population. [Copyright &y& Elsevier]

The Wechsler Adult Intelligence Scale-3rd Edition (WAIS-III) was released in 1997. Short forms developed for previous versions have not yet been investigated for the WAIS-III in special populations. A four-subtest short form by Silverstein emerged as the most promising short form in an elderly sample. [ABSTRACT FROM AUTHOR]