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AIMS: To examine associations between personality and abnormal glucose regulation. METHODS: This cross-sectional study comprised 2152 men and 3143 women (43-66 years). Oral glucose tolerance test identified 316 men and 213 women with previously unknown impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG+IGT, or type 2 diabetes. Personality traits antagonism (low agreeableness), impulsivity (low conscientiousness), hedonic capacity (high extraversion), negative affectivity (high neuroticism) and alexithymia (low openness) were measured by a self-report inventory. Based on distribution of scores, responses were divided into 'low' (<1 SD), 'middle' (±1 SD) and 'high' (>1 SD). Middle groups were considered reference groups. Prevalence odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. RESULTS: In men, OR for low antagonism was 0.3 (CI 0.2-0.6) (age- and multi-adjusted models) while in women, neither high nor low antagonism was associated to abnormal glucose regulation. Men and women with high hedonic capacity had ORs 0.5 (0.3-0.9) and 0.6 (0.4-1.0), respectively (age- and multi-adjusted models). The other scales illustrated no significant associations. CONCLUSIONS: No elevated risk of abnormal glucose regulation was observed for deviating scores on personality scales. Instead, reduced risks were indicated in men with low antagonism, and in men and women with high hedonic capacity. [ABSTRACT FROM AUTHOR]

Objective: Burnout and work engagement are generally defined as psychological states but the methods used to measure these constructs are more in line with methods used to assess psychological traits. Thus, a new instrument called the Scale of Work Engagement and Burnout (SWEBO) measuring the state mood of burnout and work engagement was developed during the fall of 2007. The purpose of the present study was to evaluate the SWEBO using psychometrical methods. Participants: The sample consisted of 2,266 newly graduated Swedish nurses and teachers. Methods: Measurement models of both burnout and work engagement were evaluated using confirmatory factor analysis (CFA). Both burnout and work engagement were also tested for measurement invariance across occupation and age. Results: The fit of the measurement model of burnout was satisfactory and it was invariant across both occupation and age. The measurement model of work engagement as initially defined did not fit the data satisfactorily. The model was therefore revised and reanalyzed. The revised model had a satisfactory fit and was invariant across occupation. Analysis of its invariance across age, however, gave ambiguous results that were difficult to interpret. Conclusions: The SWEBO presents a psychometrically sound alternative for measuring burnout and work engagement. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose was to introduce the Rasch model by showing an application in nursing research. METHODS: The Rasch model was used to examine the psychometric properties of the nursing self-efficacy (NSE) scale. Data were collected among nursing students in Sweden. Two sets of items were analysed more thoroughly: an original set of nine items with eleven response categories and a revised set of seven items with seven response categories. Invariance of the item functioning and the categorisation of the items were analysed. Targeting was examined by comparisons of the items and persons locations. Differential Item Functioning across sample groups such as gender was examined using analysis of variance. The final set of seven items was also analysed more closely with respect to possible multidimensionality and response dependence. RESULTS: The Rasch analysis of the original set of nine items showed high reliability measured by a person separation index, but it also indicated severe problems with the targeting, the categorisation of the items as well as lack of invariance. Although the revised set comprising seven items with seven categories performed better than the original item set some items showed misfit according to formal test statistics. Graphical examination showed, however, that the items operated in the right direction. The formal test of local independence of the items indicated minor signs of multidimensionality, alternatively response dependence. CONCLUSIONS: The Rasch model is useful for rigorous examination and development of measurement instruments in nursing research. The Rasch model facilitates disclosure of lack of invariance and other measurement problems that may not be easily detected by traditional analyses. Hence, the NSE-scale would probably have performed much better if the developmental work had been guided by Rasch analyses. In future work on the scale, priority should be given to improving the targeting and the categorisation of the items. [ABSTRACT FROM AUTHOR]

Objective: Personality is an aspect that can affect the symptoms and social function in individuals with psychotic disorders. Several studies have investigated personality in schizophrenia and other long-term psychotic disorders. No study has examined the stability of personality traits exceeding five years in patients with schizophrenia and related disorders. The aim of this study was to investigate the stability of personality traits over a 13-year period among patients with schizophrenia and related disorders and healthy individuals and to evaluate case-control differences., Methods: At three occasions during a 13-year period patients with schizophrenia and related disorders ( n  = 28) and healthy individuals ( n  = 57) completed Swedish universities Scales of Personality (SSP). Mean-level change and case-control differences were investigated for all the individuals using within- and between-subject analyses, respectively. Analyses were performed on three occasions for all 13 subscales and the three overall factors of SSP. Also, correlations, means, and SDs were calculated., Results: Tests of within-subject correlations showed differences in two subscales: Lack of Assertiveness, which were influenced by age, and Physical Trait Aggression, where patients' ratings were stable, whereas controls rated themselves less aggressive at a higher age. Between-subjects correlations showed differences regarding diagnosis, time, age, gender, or age × gender in nine of the 13 subscales as well as in factor Neuroticism., Conclusion: Long-term follow-up showed generally high stability of personality traits measured with SSP. Between-subject analyses over the 13 years showed that patients differed compared to controls for the SSP factor Neuroticism as well as the subscale Detachment, which is in accordance with previous studies within this population.

Objective: To investigate associations between Swedish universities Scales of Personality (SSP) and scales of the following personality instruments: Structured Clinical Interview for DSM-III-R axis II screening questionnaire (SCID-II screen), revised NEO personality inventory (NEO-PI-R), revised Chapman scales (Chapman) and the psychotic traits questionnaire (STQ)., Methods: Healthy individuals (n=406) completed self-report personality questionnaires including SSP and at least one more personality inventory. Correlations were calculated between the 13 different SSP subscales as well as SSP's three factors and factors and scales/subscales in SCID-II screen, NEO-PI-R, Chapman and STQ. The main factors of the various instruments were factor analysed. ICC were calculated., Results: SSP Neuroticism factor correlated with SCID-II cluster C (r=0.71), NEO Neuroticism (r=0.80) and Chapman Social anhedonia (r=0.62). SSP Extraversion factor correlated with NEO Extraversion (r=0.63) and SSP Aggressiveness factor with NEO Agreeableness (r=-0.62). Strong correlations between SSP factors and scales and scales of the other instruments were sparse, although weaker correlations were common., Conclusion: SSP is a useful investigation tool when measuring personality traits related to temperament-like features. SSP partly correlates well to especially three of the NEO-PI-R factors. The different personality inventories are not completely comparable to each other. Instead, they measure personality aspects in partly different ways.

Background: Personality is considered as an important aspect that can affect symptoms and social function in persons with schizophrenia. The personality questionnaire Swedish universities Scales of Personality (SSP) has not previously been used in psychotic disorder., Aims: To investigate if SSP has a similar internal consistency and factor structure in a psychosis population as among healthy controls and if patients with psychotic disorders differ from non-psychotic individuals in their responses to the SSP., Methods: Patients with psychotic disorders (n = 107) and healthy controls (n = 119) completed SSP. SSP scores were analyzed for internal consistency and case-control differences by Cronbach's alfa and multiple analysis of covariance, respectively., Results: Internal consistencies among patients were overall similar to that of controls. The patients scored significantly higher in seven (Somatic trait anxiety, Psychic trait anxiety, Stress susceptibility, Lack of assertiveness, Detachment, Embitterment, Mistrust) and lower in three (Physical trait aggression, Verbal trait aggression, Adventure seeking) of the 13 scales of the inventory. In three scales (Impulsiveness, Social desirability and Trait irritability) there was no significant difference between the scoring of patients and healthy controls., Conclusion: The reliability estimates suggest that SSP can be used by patients with psychotic disorders in stable remission. Patients score higher on neuroticism-related scales and lower on aggression-related scales than controls, which is in accordance with earlier studies where other personality inventories were used.

Background: Evidence-based practice (EBP) is emphasized to increase the quality of care and patient safety. EBP is often described as a process consisting of distinct activities including, formulating questions, searching for information, compiling the appraised information, implementing evidence, and evaluating the resulting practice. To increase registered nurses' (RNs') practice of EBP, variables associated with such activities need to be explored. The aim of the study was to examine individual and organizational factors associated with EBP activities among RNs 2 years post graduation., Methods: A cross-sectional design based on a national sample of RNs was used. Data were collected in 2007 from a cohort of RNs, included in the Swedish Longitudinal Analyses of Nursing Education/Employment study. The sample consisted of 1256 RNs (response rate 76%). Of these 987 RNs worked in healthcare at the time of the data collection. Data was self-reported and collected through annual postal surveys. EBP activities were measured using six single items along with instruments measuring individual and work-related variables. Data were analyzed using logistic regression models., Results: Associated factors were identified for all six EBP activities. Capability beliefs regarding EBP was a significant factor for all six activities (OR = 2.6-7.3). Working in the care of older people was associated with a high extent of practicing four activities (OR = 1.7-2.2). Supportive leadership and high collective efficacy were associated with practicing three activities (OR = 1.4-2.0)., Conclusions: To be successful in enhancing EBP among newly graduated RNs, strategies need to incorporate both individually and organizationally directed factors.

Background: The strength of and relationship between the fundamental elements context, evidence and facilitation of the PARIHS framework are proposed to be key for successful implementation of evidence into healthcare practice. A better understanding of the presence and strength of contextual factors is assumed to enhance the opportunities of adequately developing an implementation strategy for a specific setting. A tool for assessing context-The Context Assessment Index (CAI)-was developed and published 2009. A Swedish version of the instrument was developed and evaluated among registered nurses. This work forms the focus of this paper., Purpose: The purpose of this study was to translate the CAI into Swedish, adapt the instrument for use in Swedish healthcare practice and assess its psychometric properties., Methods: The instrument was translated and back-translated to English. The feasibility of items and response scales were evaluated through think aloud interviews with clinically active nurses. Psychometric properties were evaluated in a sample of registered nurses (n = 373) working in a variety of healthcare organisations in the Stockholm area. Item and factor analyses and Cronbach's alpha were computed to evaluate internal structure and internal consistency., Result: Sixteen items were modified based on the think aloud interviews and to adapt the instrument for use in acute care. A ceiling effect was observed for many items and the originally identified 37 item five-factor model was not confirmed. Item analyses showed an overlap between factors and indicated a one-dimensional scale., Discussion: The Swedish version of the CAI has a wider application than the original instrument. This might have contributed to the differences in factor structure. Different opportunities for further development of the scale are discussed., Conclusions: Further evaluation of the psychometric properties of the CAI is required., (© 2012 The authors. World Views on Evidence-Based Nursing © Sigma Theta Tau International.)

The aim was to study the validity of 2 personality instruments, the Health-Relevant Personality Inventory (HP5i) and the Junior Temperament and Character Inventory (JTCI), among adolescents with a substance use problem. Clinical interviews were completed with 180 adolescents and followed up after 12 months. Discriminant validity was demonstrated in the lack of correlation to intelligence in both instruments' scales. Two findings were in support of convergent validity: Negative affectivity (HP5i) and harm avoidance (JTCI) were correlated to internalizing symptoms, and impulsivity (HP5i) and novelty seeking (JTCI) were correlated to externalizing symptoms. The predictive validity of JTCI was partly supported. When psychiatric symptoms at baseline were controlled for, cooperativeness predicted conduct disorder after 12 months. Summarizing, both instruments can be used in adolescent clinical samples to tailor treatment efforts, although some scales need further investigation. It is important to include personality assessment when evaluating psychiatric problems in adolescents.

Background: Beliefs about capabilities, or self-efficacy, is a construct originating in social cognitive psychology. Capability beliefs have been found to be positively associated with intention and healthcare practice behaviour. A measure of an individual's beliefs about his/her capability to apply the components of evidence-based practice (EBP) has potential to be useful in implementation research., Aims: To evaluate the concurrent validity and internal structure of a new scale measuring nurses' capability beliefs regarding EBP., Methods: Data were taken from a prospective longitudinal study in Sweden (the Longitudinal Analyses of Nursing Education and Entry in Worklife [LANE]). A cohort of nursing students who graduated in the autumn of 2004 that was followed up 2 years after their graduation was used (n= 1,256). Concurrent validity was tested relating different levels of capability beliefs to extent of research use and application of EBP. An item-response approach was applied in the evaluation of internal structure of the proposed scale (six items)., Results: The psychometric analyses indicated that the six items could be summed to reflect a one-dimensional scale. Nurses with the highest level of capability beliefs reported that they used research findings in clinical practice more than twice as often as those with lower levels of capability beliefs. They also participated in the implementation of evidence seven times more often., Implications: There is a need for further studies of the construct and predictive validity of the scale. It should also be validated in other groups of health professionals. Learning including mastery experiences, role modelling, social persuasion, and manageable stress could be used in undergraduate education as well as practice development to increase beliefs about capabilities which might open the way to increased application of EBP in healthcare practice., Conclusions: This new measure is well grounded in social cognitive theory, functions as a one-dimensional scale and possesses promising properties of concurrent validity., (©2012 Sigma Theta Tau International.)

Background: Early-career burnout among nurses can influence health and professional development, as well as quality of care. However, the prospective occupational consequences of study burnout have not previously been investigated in a national sample using a longitudinal design., Objectives: To prospectively monitor study burnout for a national sample of nursing students during their years in higher education and at follow-up 1 year post graduation. Further, to relate the possible development of study burnout to prospective health and life outcomes, as well as student and occupational outcomes., Design: A longitudinal cohort of Swedish nursing students (within the population-based LANE (Longitudinal Analysis of Nursing Education/Entry) study) from all sites of education in Sweden was surveyed annually. Data were collected at four points in time over 4 years: three times during higher education and 1 year post graduation., Participants: : A longitudinal sample of 1702 respondents was prospectively followed from late autumn 2002 to spring 2006., Methods: Mean level changes of study burnout (as measured by the Oldenburg Burnout Inventory, i.e. the Exhaustion and Disengagement subscales) across time, as well as prospective effects of baseline study burnout and changes in study burnout levels, were estimated using Latent Growth Curve Modeling., Results: An increase in study burnout (from 30% to 41%) across 3 years in higher education was found, and levels of both Exhaustion and Disengagement increased significantly across the years in education (p<0.001). Baseline levels, as well as development of study burnout, predicted lower levels of in-class learner engagement and occupational preparedness in the final year. At follow-up 1 year post graduation, earlier development of study burnout was related to lower mastery of occupational tasks, less research utilization in everyday clinical practice and higher turnover intentions., Conclusions: The results suggest that study burnout may have interfered with learning and psychological well-being. Aspects related to work skills and intention to leave the profession were also affected. Thus, burnout development during higher education may be an important concern, and effective preventive measures to counteract burnout development may be necessary already at the outset of nursing education., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Background: Newly qualified and inexperienced nurses are at particular risk of suffering emotional exhaustion and burnout in unsupportive practice environments. Despite new nurses' potential vulnerability, development of burnout after graduation has rarely been studied longitudinally and in relation to demographic and educational characteristics prior to working life entry, i.e. during education., Objectives: To identify and compare typical change trajectories (i.e. common patterns of intra-individual development) in burnout symptoms for new graduate nurses annually over a three-year period, during which there was reason to believe that this group was especially vulnerable., Design: A prospective longitudinal and national cohort of 1153 nurses within the population-based LANE study (Longitudinal Analyses of Nursing Education), where new graduate nurses were assessed four times annually, i.e. in their final year of nursing education and three times post graduation (after 1, 2 and 3 years)., Participants: A longitudinal sample of 997 respondents was prospectively followed., Methods: Within-group changes in burnout levels were analysed using a repeated-measures analysis of variance, and cluster analytic techniques were used to identify typical trajectories of burnout., Results: At group level, mean levels of burnout were rather stable across time. However, underlying these levels we identified eight change trajectories, explaining 74% of all individual variation; seven of them reflected significant changes across time. Almost every fifth nurse reported extremely high levels of burnout at some point during their first three years after graduation. Changes in burnout levels were accompanied by concurrent changes in depressive symptoms and intention to leave the profession. This study also showed that negative development of burnout was predicted by not feeling well prepared for a nursing job, lacking study interest, high levels of performance-based self-esteem and depressive mood in the final year of education., Conclusions: An investigation of burnout symptoms over time disclosed numerous development patterns, some of which were stable while others changed significantly. Hence, this study gave a more nuanced picture of burnout development among new graduate nurses, highlighted by eight different trajectories. Regarding the time frame, nearly every second new graduate showed a significant increase in levels of burnout during their second year post graduation., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Objective: When entering employment many beginning teachers experience a reality shock and a crisis of competence. These two factors, in combination with high levels of job demands and low levels of job resources, may lead to the development of burnout. The purpose of the study was to investigate how individual characteristics, the educational context, and the work context predicted levels of burnout and work engagement during this transition period., Participants: The sample consisted of 1290 beginning teachers from Sweden., Methods: Data were collected using surveys during the final year of education and during the initial period of employment. Data were analyzed using hierarchical regression., Results: Job demands, job resources, and spillover between private life and work accounted for the largest amount of explained variance in both burnout and work engagement. Job demands were more strongly related to burnout, whereas job resources more strongly related to work engagement. The predictors with the greatest relative influence on both burnout and work engagement were unmet expectations and mastery of skills., Conclusions: The results support the importance of the work context's impact on burnout and work engagement. Additionally, the interaction between private life and work should be further studied in future studies.

Background: Both childhood trauma and violent behavior are important risk factors for suicidal behavior. The aim of the present study was to construct and validate a clinical rating scale that could measure both the exposure to and the expression of violence in childhood and during adult life and to study the ability of the Karolinska Interpersonal Violence Scale (KIVS) to predict ultimate suicide in suicide attempters., Method: A total of 161 suicide attempters and 95 healthy volunteers were assessed with the KIVS measuring exposure to violence and expressed violent behavior in childhood (between 6-14 years of age) and during adult life (15 years or older). The Buss-Durkee Hostility Inventory (BDHI), "Urge to act out hostility" subscale from the Hostility and Direction of Hostility Questionnaire (HDHQ), and the Early Experience Questionnaire (EEQ) were used for validation. All patients were followed up for cause of death and a minimum of 4 years from entering in the study., Results: Five patients who committed suicide within 4 years had significantly higher scores in exposure to violence as a child, in expressed violent behavior as an adult, and in KIVS total score compared to survivors. Suicide attempters scored significantly higher compared to healthy volunteers in 3 of the 4 KIVS subscales. There were significant correlations between the subscales measuring exposure to and expression of violent behavior during the life cycle. BDHI, Urge to act out hostility, and EEQ validated the KIVS., Conclusions: Exposure to violence in childhood and violent behavior in adulthood are risk factors for completed suicide in suicide attempters. Behavioral dysregulation of aggression is important to assess in clinical work. The KIVS is a valuable new tool for case detection and long-term clinical suicide prevention., (Copyright 2010 Physicians Postgraduate Press, Inc.)

Background: Cherniss's pioneering research on burnout, based on grounded theory, focused specifically on competence crisis among new graduates, and identified negative attitude changes as the core phenomenon in the progression from competence crisis into early career burnout. In this model, the two main burnout dimensions of exhaustion and dysfunctional coping are ordered sequentially; i.e., initial exhaustion develops, due to dysfunctional coping (cynicism and disengagement), into burnout., Objective: To test the sequential-developmental model of burnout originally proposed by Cherniss, using a psychometric approach., Design: A sample of 933 early-career nursing professionals, recruited from a Swedish population-based cohort (response rate 81%), were assessed three years after graduation, using items from a burnout inventory. Data were analysed using the Rasch measurement model., Results: The psychometric tests showed that data adhere to a sequential-developmental model when examined using the one-parameter item response approach. When tested against external variables, the prevalence of low mood, low levels of job performance and health problems increased monotonically along this sequential-developmental model of early career burnout., Conclusion: Among early-career nursing professionals burnout may be operationalized as a one-dimensional sequential-developmental model. This model resembles the results found in the literature on transition and socialization, and the association between these psychometric results and studies on nursing students' transition and socialization into working life are discussed., (Copyright 2009 Elsevier Ltd. All rights reserved.)

Research on the biological underpinnings of personality can provide leads to the pathophysiology of psychiatric disorders. In particular, interpersonal aspects of behavior are a common problem during the course of psychiatric illness. Animal research has demonstrated a role for the dopamine system in social behaviour, and recent molecular imaging studies have shown a negative correlation between dopamine D2-receptor binding in the striatum and social desirability. The emotional and cognitive aspects of social behavior suggest involvement of brain regions outside of the striatum, such as limbic structures. The aim of the present study was to explore associations between the personality trait social desirability and dopamine D2-receptor binding in both striatal and extrastriatal brain regions. We examined 16 control subjects with Positron Emission Tomography and the radioligands [(11)C]raclopride and [(11)C]FLB 457, in relation to social desirability in the inventory Swedish universities Scales of Personality. [(11)C]raclopride D2-receptor binding in the striatum showed negative correlations to social desirability scores, corroborating previous findings. Furthermore, a correlation of a higher statistical significance was demonstrated for [(11)C]FLB 457 binding in the hippocampal-amygdala complex. A separate analysis of social desirability items in relation to a model of interpersonal behaviour revealed that the associations were driven by items reflecting high submissiveness and high affiliation. Taken together with previous evidence on D2-receptor binding and social behaviour, a role for dopaminergic neurotransmission in regulating displays of dominance vs. submissive behaviour is proposed., (Copyright (c) 2009 Elsevier B.V. All rights reserved.)

Background: Evidence-based practice (EBP) is a worldwide approach to improving health care. There is, however, a shortage of studies examining whether or not newly graduated health care professionals are actually applying EBP in their daily work., Objectives: To examine the application of EBP in clinical practice by registered nurses (RNs) 2 years post graduation and to explore whether the application of EBP differed with regard to the clinical settings where RNs were working., Method: A cross-sectional design using a national sample. Data were collected in 2007 from 987 RNs (response rate 76%). Six items measuring respondents' self-reported extent of applying EBP were used. Results Of the 987 RNs, 19% formulated questions and performed searches in data bases, 56% used other information sources, 31% appraised the literature, 30% participated in practice development and 34% participated in evaluating clinical practice. A greater proportion of the RNs working in elder care applied EBP compared with the RNs working in hospitals, psychiatric care and primary care., Conclusions: The RNs applied the components of EBP to a rather low extent 2 years post graduation despite EBP being an important objective in Swedish health care and educational programmes since the 1990s. These findings support other studies reporting the implementation of EBP in organizations as a complex and often slow process. The differences in the RNs extent of applying EBP in relation to their workplace indicate that contextual factors and the role of the RN in the organization are of importance for getting EBP into practice.

The study aims to test the reliability and validity of the Estonian version of the Swedish universities Scales of Personality (SSP), and to characterize the position of the SSP-measured traits within the basic personality dimensions of the five-factor model. A total of 529 participants completed the Estonian version of the SSP. A subsample of 197 persons completed the SSP together with the Revised NEO Personality Inventory (NEO-PI-R). The internal consistency of the SSP scales was satisfactory. Principal component analysis yielded three factors representing neuroticism, aggression and disinhibition. The factor solution obtained in the Estonian sample was similar to the original SSP study in the Swedish normative sample. NEO-PI-R Neuroticism had highest correlations with SSP neuroticism factor scales. Extraversion had strongest relationship with adventure seeking and low detachment. Agreeableness correlated positively with SSP social desirability and negatively to aggression-irritability scales. Conscientiousness facet Deliberation correlated with Impulsiveness. The Estonian SSP showed acceptable reliability and validity, which confirms that SSP is applicable in different social and cultural background. The SSP measures traits that correspond to the major personality models. The SSP characterizes three broad dimensions of personality, namely neuroticism, disinhibition and aggression, which are useful in assessment of personality correlates of mental disorders.

Aim: To assess the psychometric properties of a comprehensive tool for assessing psychosocial work characteristics(the QPSNordic), focusing on measurement invariance (MI) across occupations., Methods: QPSNordic consists of 26 scales covering task, individual, and organizational aspects of work. Multiple group confirmatory factor analyses were performed in order to elucidate MI across a variety of occupational groups., Subjects: Private sector employees and health care workers from the public sector participated. Equal size (n = 500) groups from six different occupations were drawn and entered in multiple group confirmatory factor analyses for assessment of MI., Results: Nine of the 24 analysed scales functioned well across all occupational groups and could thus be used for valid comparisons across professions. The majority of the remaining scales showed MI at least across some groups., Conclusion: With some exceptions, the QPSNordic has good psychometric properties. Scales measuring organizational aspects of work could also be used across professional groups, enabling valid comparisons between differing workplaces and occupations.

Aim: To prospectively explore the quality of the relationship between significant others and patients during lung cancer, based on the perceptions of the significant others., Method: In a sample of 91 significant others, longitudinal data were collected during the first year after diagnosis, and explored on group level and as individual patterns over time., Results: Relational quality was skewed towards high quality, although 30% of the significant others reported low levels close to diagnosis. Forty-eight percent reported stability in the quality of their relationship during the disease trajectory. Within this group, 36% reported low levels of relational quality. Fifty-two percent reported change in quality of relationship and four typical patterns of change were identified. Two showed approximate linear changes in either a positive direction (15%) or a negative direction (49%), and two showed non-linear changes with a temporary ascending curve (11%) or a descending curve (26%). This implies that a change towards low levels of relational quality was most common., Conclusion: The present results show that illness may be a trigger for change in relational quality, which may have implications for future family-centred practice and research, since previously high relational quality has been linked to improved emotional well-being.

Associations between personality and health may be influenced by contextual factors varying across studied cohorts. Moreover, measurement bias related to contextual factors could also influence these associations. Gender and age have been discussed as important contextual factors when studying personality and health outcomes. An examination of measurement invariance across gender and age may therefore be warranted. In the present study, measurement invariance across age and gender was examined for a five-factor model of personality traits in which scales have been included to operationalise lower-order traits related to health-behaviour or health outcomes. Using multi-group confirmatory factor analysis on a population based cohort (n= 5700), all important parameters of the measurement model were found to be invariant. On the basis of this invariant model, hypotheses of mean differences across age and gender in personality traits were tested. These results were discussed in relation to meta-analyses on personality change and gender differences in personality.

Objectives: The assessment of job demands, a pivotal concept in the study of work stress, is often problematic. Part of the problem is that people differ in their perception of whether a given task is overly demanding, or merely a welcome challenge. This study address this problem by examining alternative response formats for job demands that include the respondents' appreciation of this aspect. Another job stress dimension known to be important for health, leadership, was used for comparison and the association with health measures were examined., Methods: A professionally homogenous group of 105-white collar workers participated in the study. A questionnaire assessing two job characteristics, demand and leadership, was used with four alternative response formats. The selected items were taken from the General Nordic Questionnaire for Psychological and Social Factors at Work (the QPS(Nordic)). Five indices from the SF-36 were used to reflect physical and mental health. Part correlations, taken from a multiple regression procedure were used to elucidate the unique contribution of response format in the association with health variables., Result: For the assessment of Demand, response formats that tapped the employee's experience of the demands performed best. This was in contrast to Leadership scales, where an alternative response format did not contribute any unique information., Conclusion: Insofar as interventions are aimed at improving worker's health, it seems reasonable to recommend that the workers should also be asked if the job demands are actually experienced as overly demanding.

A perfluorinated ketone, 2-trifluoromethyl-1,1,1,2,4,4,5,5,5-nonafluoro-3-pentanone, has been investigated to determine several physical and spectroscopic properties. It was found to exhibit fluorescence similar to that of acetone, emitting over the 360-550 nm range with a peak near 420 nm when excited at 355 nm. This compound's emission is nearly unaffected over a wide range of temperature and pressure in an argon bath gas. Its fluorescence efficiency was found to be three times higher than that of acetone. Combined with low reactivity and thermal stability up to 500 degrees C, this makes the material an excellent tracer for spectroscopic measurement techniques.

Several aspects of the Gender Diagnosticity (GD) approach of Lippa (1995) to measuring the psychological trait of masculinity-femininity within sexes were explored in four samples ranging from 363 to 5,859 individuals, including Swedish and Australian adults, U.S. elderly, and Australian adolescents. Two ways of deriving GD scales yielded highly similar results. Moderate stability of individual differences was found across ages 12 to 16 among adolescents, but substantial shifts over age occurred in relationships with Eysenck scales. Considerable generality of GD scales was obtained across languages and populations. Substantial heritabilities (about 40%) and minimal effects of shared family environments suggest that within-sex masculinity-femininity behaves as a fairly typical personality trait. Cross-age continuity appeared mainly to reflect the influence of the genes.

The gender diagnosticity (GD) approach of Lippa (1995) was used to evaluate the relationship of within-sex differences in psychological masculinity-femininity to a genetic characteristic, the length of a repeated CAG sequence in the X-linked androgen receptor (AR) gene. Previously assessed adult samples in Australia and Sweden were used for this purpose. A weak relationship (correlations in the range .11 to .14) was obtained in both countries. Additional data from adolescent twins from Australia (12-, 14-, 16-year-olds) did not confirm such a relationship at those ages, especially for males. The fact that this sample consisted of twins permitted two kinds of within-pair comparisons: (1) Did the dizygotic twin who had the longer AR sequence have the higher GD score? (2) Was one twin's GD score more highly correlated with the other twin's AR score in MZ than in DZ pairs? The answer in both cases was negative. Clarification of these relationships will require large samples and measurements at additional ages.

Psychoanalytic psychotherapy in clinical practice is traditionally a long-term treatment conducted by well-trained psychotherapists. However, very few studies have been published that evaluate the effects of such treatment. To redress this lack of studies, 55 individuals selected for long-term psychoanalytic psychotherapy (average, 3 years) were invited to participate in a naturalistic study. The psychotherapists had a mean of 15 years of professional experience. The 36 patients who completed psychotherapy manifested a substantial reduction in symptomatic suffering and decreased levels of character pathology, as measured by the Karolinska Psychodynamic Profile (KAPP) and the Karolinska Scales of Personality. Generally, such changes were not found in the individuals who did not engage in treatment. In the therapy group, improvements were found on eight KAPP subscales defining different aspects of character: Intimacy and Reciprocity, Frustration Tolerance, Regression in the Service of the Ego, Coping with Aggressive Affects, Conceptions of Bodily Appearance and their Significance for Self-esteem, Sexual Function, Sexual Satisfaction, and Personality Organization. The results indicate that individuals who engaged in psychotherapy improved their capacity to handle crucial aspects of life and reduced their symptomatic suffering.

This naturalistic study focuses on changes in central relationship patterns after long-term dynamic psychotherapy (mean duration = 3 years) with experienced psychotherapists. Relationship patterns before and after treatment were assessed according to the core conflictual relationship theme (CCRT) method, which includes 3 components: most frequent wish, response from others, and response of the self. Overall, the main CCRT did not change substantially after therapy. There were, however, a few significant changes for some of the standard cluster categories after therapy. Patients' flexibility regarding their use of different wishes and negative responses from others and the self increased, as did the frequency of positive responses from others and the self. The positive changes in relationship patterns were only rarely related to changes in symptoms and character pathology.

Very few studies have examined the relationship between personality traits and long-term postoperative psychosocial adjustment. In a sample of 46 patients, we examined the relation between personality traits before pelvic pouch surgery for ulcerative colitis and psychosocial adjustment seven years postoperatively, controlling for the effects of surgical functional outcome. The Karolinska Psychodynamic Profile (KAPP) was used for personality assessment. Surgical functional outcome scales and the Psychosocial Adjustment to Illness Scale were also used. As assessed by the KAPP, poor frustration tolerance, long-standing preoperative problems in sexual functioning, perfectionistic body ideals, and lack of alexithymia predicted poorer postoperative long-term psychosocial adjustment in the areas of health concerns, sexuality, family relations, and psychological distress. Surgical functional outcome itself was a poor predictor of long-term adjustment. The results indicate that it may be beneficial to take personality factors into account in preoperative assessment., (Copyright 2003 Wiley Periodicals, Inc. J Clin Psychol.)

We have previously identified mutations in exon three in NURR1 (NR4A2) in two patients with schizophrenia (SZ) and one patient with bipolar disease with psychotic symptoms. In the present study we analyzed the promoter region of NURR1 and identified five polymorphic sites: three were found to be in strong linkage disequilibrium with a previously identified polymorphic site in the sixth intron. One polymorphism of this haplotype and the two other independent polymorphisms were investigated for their possible association with SZ and Parkinson's disease (PD) by comparing their frequencies in a Swedish material consisting of 134 subjects with SZ and 207 matched controls and 108 subjects with PD and 125 matched controls. Exon 1 was also investigated in our Parkinson and control material but no variances were found. The distributions of the two most informative polymorphisms in the promoter were investigated in an American material as well consisting of 141 subjects with SZ and 139 matched controls. Furthermore, the identified markers were screened for association with putative endophenotypes of SZ in the Swedish material. The distribution of sequence variants among the Swedish controls matched for SZ was investigated with regard to personality. No significant genotype or allelic association of the three sequence variants with SZ or PD was found. Several comparisons regarding endophenotypes or personality indicated association at the 5% confidence level, although correction for multiple testing rendered none of these findings significant. We conclude that the identified polymorphic sites in the human NURR1 are unlikely to be involved in conferring susceptibility for SZ or PD in our patient material., (Copyright 2003 Wiley-Liss, Inc.)

Studies in Sweden and Australia have examined the relationship between number of CAG repeats in the androgen receptor gene and psychological traits - three Masculinity-Femininity (M-F) measures in Australia, and the Karolinska Scales of Personality (KSP) in Sweden. The present study derived M-F scales from the KSP items, and scales corresponding to several KSP scales from the items of the inventories used in Australia, to permit cross-validation of the Australian results in the Swedish sample, and vice versa. The derivation of scales was facilitated by the fact that items from both inventories had been used with a large twin sample in the US. Correlation of the derived scales with androgen receptor gene CAG-repeat scores for women in the Australian and Swedish samples failed to provide clear evidence of replication of either set of original correlations in the other sample, although there were a few hints of consistency. It was concluded that if the number of CAG repeats on this gene is related to psychological traits at all, the relationship is a weak one.

Background: There is a lack of longitudinal long-term studies of quality of life (QOL) after surgery with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis, where cohorts of patients are used as their own controls., Methods: Forty ulcerative colitis patients who had undergone IPAA were prospectively assessed while they had a temporary ileostomy, and at a median of 18 months and 7 years after ileostomy closure. QOL was measured with the Psychosocial Adjustment to Illness Scale and the Well-Being Profile., Results: QOL was good at all three time points and, with some exceptions, did not change significantly between the assessments. There was a high degree of stability in the patients' evaluation of their QOL over time., Conclusions: QOL was already good when the patients had a temporary ileostomy and generally did neither improve nor deteriorate during 7 years after ileostomy closure. QOL was also quite stable in terms of individual differences.

Background: Personality traits have shown considerable heritable components. Striatal dopamine D(2) receptor density, as determined by positron-emission tomography, has been associated with detached personality, as assessed by the Karolinska Scales of Personality. A putative functional promoter polymorphism in the dopamine D(2) receptor gene (DRD2), -141C ins/del, has been associated with dopamine D(2) receptor density., Methods: In this study healthy subjects (n = 235) who filled in at least one of several personality questionnaires (Karolinska Scales of Personality, Swedish Universities Scales of Personality, Health-relevant Five-factor Personality Inventory, and Temperament and Character Inventory) were analyzed with regard to the DRD2 -141C ins/del variant., Results: There was an association (p =.001) between the DRD2 -141C ins/del variant and Karolinska Scales of Personality Detachment scale, indicating higher scores in subjects with the -141C del variant. There were also associations between the DRD2 -141C ins/del variant and a number of Karolinska Scales of Personality and Swedish Universities Scales of Personality Neuroticism-related scales, but of these only Swedish Universities Scales of Personality Lack of Assertiveness scale (p =.001) survived correction for multiple testing., Conclusions: These results add further support for the involvement of dopamine D(2) receptor in certain personality traits. The results should be treated with caution until replicated.

Background: Recently, linkage disequilibrium mapping of the major histocompatibility complex region on the short arm of human chromosome 6 suggested that the NOTCH4 locus is highly associated with schizophrenia., Objectives and Methods: We analysed two polymorphisms in this gene in Swedish schizophrenic patients ( =74) and control subjects ( =135). The NOTCH4 variants were also analysed in schizophrenic patients with regard to subdiagnosis, age at first hospitalization, abuse/dependence of alcohol, solvents, or drugs, previous suicide attempts, extrapyramidal symptoms, treatment with anticholinergic drugs, and response to anti-psychotic drug treatment. Control subjects were scrutinized with regard to personality, another partially heritable trait suggested being of importance in schizophrenia. In addition, two intermediate endophenotypes suggested being of importance in schizophrenia, dopamine D(2) receptor density in striatum and monoamine metabolites in cerebrospinal fluid, respectively, were investigated with regard to the two NOTCH4 variants., Results: There was no significant association between the patients and the controls for the two investigated polymorphisms neither for the parameters analysed in the schizophrenia material. The NOTCH4 SNP2 variant, an A-->G substitution, was associated with the Karolinska Scales of Personality Irritability scale. The NOTCH4 (CTG)(n) variant was associated with the revised NEO personality inventory Extraversion and Activity (E4) scales. However, after correction for multiple testing, no difference remained significant. The results for the endophenotypes and the polymorphisms were non-significant., Conclusions: The present study does not support that the investigated NOTCH4 variants have a major influence on susceptibility to schizophrenia or related neurobiological traits.

Dopamine receptor gene variation has been hypothesized to influence personality traits characterized by novelty seeking and related traits. We analyzed a dopamine D(3) receptor gene (DRD3) variant in a Swedish population (n = 373) investigated with one or more of several personality questionnaires. No significant relationships were found between DRD3 genotypes and any of the 15 Karolinska Scales of Personality (KSP) and five Health-relevant Personality 5 factor inventory (HP5i) scales. The DRD3 variant was associated with some scales related to novelty seeking: the Swedish universities Scales of Personality (SSP) Adventure Seeking and the revised NEO personality inventory (NEO-PI-R) Fantasy (O1) and Order (C2) scales. There were also associations with the Temperament and Character Inventory (TCI) Cooperativeness and Compassion (C4) scales. After correction for multiple testing, however, no significant difference remained. We conclude that the investigated DRD3 polymorphism does not have a major impact on personality in the investigated population., (Copyright 2003 Wiley-Liss, Inc.)

Attempts to link transmitter system genes to certain aspects of personality have been performed. Several monoamine-related gene variants have been investigated. We previously reported an association between a transcription factor activating protein-2beta (AP-2beta) variant and anxiety-related personality traits as estimated by Karolinska Scales of Personality (KSP). To confirm this reported association, we have, in the present study, analysed an enlarged group of healthy volunteers (n = 370) with regard to AP-2beta genotype and personality traits. For estimation of personality traits, individuals completed 5 different personality questionnaires, i.e. Swedish Universities Scales of Personality (SSP), Health-Relevant 5- Factor Personality Inventory (HP5i), Temperament and Character Inventory, the Revised NEO Personality Inventory and KSP. In contrast to men, women having two long AP-2beta alleles displayed lower scores for muscular tension (KSP; F = 10.65, p = 0.0013), somatic trait anxiety (SSP; F = 7.18, p = 0.0081), trait irritability (SSP; F = 4.51, p = 0.032), mistrust (SSP; F = 4.01, p = 0.0468) and negative affectivity (HP5i; F = 10.20, p = 0.0017) than women with at least one short allele. The data presented in this study, together with our previously published data, suggest that AP-2beta intron 2 genotype is associated with low levels of anxiety-related personality traits in women. Hence, these data further suggest the human AP-2beta gene as a novel candidate gene in personality., (Copyright 2003 S. Karger AG, Basel)

Monoamine oxidase type A (MAOA) has been implicated to be part of mechanisms underlying human temperament and psychiatric disorders. We hypothesised that a functional polymorphism in the 5' untranslated region of the MAOA gene is associated with specific personality traits. In 371 healthy Caucasians, we estimated personality traits by the use of the Karolinska Scales of Personality (KSP), Scandinavian Universities Scales of Personality, Health-Relevant 5-Factor Personality inventory, Temperament and Character Inventory and the revised NEO Personality Inventory. In the same subjects, we analysed the genotype of a polymorphic region consisting of a variable number of a 30-bp repeat sequence located approximately 1.2 kb upstream of the MAOA gene. After correction for multiple testing, no statistically significant differences between MAOA genotype and personality were observed in men (n = 206) nor in women (n = 165). We conclude that the structure of this MAOA promoter region does not have a large impact on the expression of personality characteristics in the present Swedish population., (Copyright 2003 S. Karger AG, Basel)

Human family and twin studies have established considerable heritable components influencing individual differences in personality traits as assessed by self-report questionnaires. We have investigated a trinucleotide repeat polymorphism in the androgen receptor gene and personality traits. Healthy Swedish subjects (n = 335) were assessed with the Karolinska Scales of Personality inventory. There were tendencies (P > or = 0.006) in some scales indicating possible relationships between the androgen receptor allele length and personality traits related to dominance and aggression. However, after correction for multiple testing, no significant differences were found. We conclude that no significant association could be found between the androgen receptor polymorphism investigated and any personality trait, although the tendencies found are worthwhile subjects for replication attempts.

Among theories of biological underpinnings to personality traits, different mechanisms of the serotonergic system are perhaps the most common factors suggested to influence individual differences in personality traits. We have investigated two frequent variants in the serotonin 2A receptor gene (5-HT2A) and personality traits. Healthy Swedish subjects (n = 304) were assessed with the Karolinska Scales of Personality (KSP) inventory. After correction for multiple testing, no significant differences were found. We conclude that the investigated 5-HT2A gene variants do not significantly influence personality as assessed by the KSP in the present population.

The Core Conflictual Relationship Theme (CCRT) method is one of the most widely used and tested instruments developed within a psychoanalytic context for assessing central relationship patterns or characteristic patterns of relating to others. The Swedish version of the Central Relationship Questionnaire (CRQ), a recently developed self-report instrument based on the CCRT, was tested in a sample of Swedish psychology students (31 men, 60 women) and compared with responses of Swedish outpatients (15 men, 15 women) and North American students (49 men, 49 women). The subscales of the Swedish CRQ showed acceptable internal consistency and correlated with each other in a predictable fashion, displaying a pattern of intercorrelations similar to the English version. The CRQ showed meaningful patterns of correspondence with self-reported interpersonal problems as well as meaningful differences between the Swedish students and Swedish outpatients, indicating preliminary convergent and divergent validity.