Biomedical subjects

Thomas D Meyer

Publications and source records attributed to Thomas D Meyer.

14 recordsLinked to original sources

PubMed2006

The Hypomania Checklist (HCL-32): its factorial structure and association to indices of impairment in German and Swedish nonclinical samples.

BACKGROUND: Bipolar disorders are often not recognized. Several instruments were developed but none primarily focused on hypomania. The Hypomania Checklist (HCL) is aimed at the identification of bipolarity in outpatients. Using a German and Swedish sample, we investigated if the factor structure in nonclinical samples is similar to the one reported for outpatient samples. Furthermore, we tested if people who probably had a lifetime history of hypomania report more depression or other signs of impairment and if current depression is associated with lifetime hypomania. METHOD: In the German study, participants completed the HCL-32 as an online questionnaire that also included questions about lifetime and current depression (n = 695), whereas the Swedish data relied on the paper-and-pencil version of the HCL-32 completed by a random sample from a representative population sample (n = 408). RESULTS: The factor structure of the HCL-32 was fairly similar in both samples and to the ones presented by Angst et al (J Affect Disord 2005;88:217-33). People reporting "highs" (> or =4 days and experiencing negative consequences) not only endorsed more HCL-32 symptoms but also had higher rates of current and former depression and psychotherapy. Level of current depression was also associated with lifetime hypomanic symptoms. DISCUSSION AND LIMITATION: An "active-elated" and "risk-taking/irritable" factor of hypomania can be distinguished with the HCL-32 in clinical and nonclinical samples. Based on our results, the HCL-32 might even be useful as screening tool in nonclinical samples and not only in depressed outpatients. However, our data do not allow estimating sensitivity and specificity of the HCL-32 because structured clinical interviews were not included.

Adolescent↗

PubMed2006

Current and former depression and their relationship to the effects of social comparison processes. Results of an internet based study.

BACKGROUND: According to cognitive vulnerability stress models of depression, negative cognitions are supposed to be stable characteristics of depressed individuals even between depressive episodes. Depressed people also interpret social information more negatively than healthy people, perhaps even between depressive episodes. Frequency of social comparison processes is correlated with low self-esteem and uncertainty, which is common in depression. QUESTIONS: Do people with lifetime depressive episodes engage in social comparisons more often and do they react more negatively to an upward comparison than normal controls? And if they do, is this just due to current depressive symptoms? METHOD: A questionnaire including the BDI II was administered as an internet link to all students or employees of a large University. 913 participants responded. After assessing social comparison orientation we used an upward comparison paradigm by asking the participants to compare themselves with a better-off person on several dimensions. Finally lifetime and current depressive symptoms were assessed. RESULTS: Depressed persons engage in social comparison processes more often than normal controls. Positive affect decreased in the whole sample as a reaction of to social comparison. This effect was stronger among persons with at least one depressive episode in the past, and this was not just due to current depression. CONCLUSION: Depressed persons engage more often in social comparison processes and they additionally react more negatively to upward comparisons than healthy controls. The result that even those not currently depressed with lifetime depressive episodes show a similar negative reaction to an upward comparison indicates that social comparisons are situations that interact with a stable cognitive vulnerability leading to negative affect and stronger negative reactions.

Adolescent↗

PubMed2006

Mood fluctuations in people putatively at risk for bipolar disorders.

OBJECTIVES: The dysregulation of the Behavioural Activation System (BAS) is discussed as a vulnerability marker for bipolar disorders, resulting in fluctuations of activity and mood. People putatively at risk for bipolar disorders (BD) should therefore show mood fluctuations. METHOD: Using the "Hypomanic Personality Scale" (HPS) three groups of young adults with high (N=17), medium (N=19), and low scores (N=18) were selected and completed a 28-day diary including CES-D and PANAS. RESULTS: People at risk for bipolar disorders exhibited high levels of manic symptoms, positive and negative affect. They also generally reported more mood instability. CONCLUSIONS: The results support the hypothesis that fluctuations of mood and symptoms might be a core characteristic of the hypothesized vulnerability for BD. These fluctuations of mood were, however, not restricted to positive affect as a dysregulation of the BAS would suggest.

Adult↗

PubMed2005

Is there evidence for social rhythm instability in people at risk for affective disorders?

Social rhythm disruptions are thought to be related to the etiology of affective symptoms. 'Hypomanic personality' and 'rigidity' are hypothesized to be risk factors for affective disorders. We examined whether people scoring high on such scales would demonstrate instability of social rhythms and sleep. In a short-term prospective diary study with one group factor, the following three groups were selected from a non-university student sample: 'bipolar risk' (scoring high on the 'Hypomanic Personality Scale'; n=56); 'Unipolar risk' (scoring high on the 'Rigidity Scale'; n=37); and a control group (scoring low on both scales; n=48). The participants completed ratings of their activities and sleep for 28 days. People at risk for bipolar disorders showed a lower regularity of daily activities than controls. Their sleeping pattern was not characterized by fewer but by more variable hours of sleep. The unipolar risk group did not differ from the control group at all. Despite some limitations, there is partial evidence for social rhythm and sleep irregularities in people putatively at risk for bipolar disorders. Further research is, however, needed to replicate and extend these results.

Adult↗

PubMed2005

Are there attentional deficits in people putatively at risk for affective disorders?

BACKGROUND: Schizophrenia is associated with attentional dysfunctions. In bipolar disorder, there is also evidence for sustained attention deficits. Therefore, we hypothesized that risk for bipolar disorder but not for unipolar depression might be associated with attentional abnormalities as well. METHOD: Using the Hypomanic Personality Scale (HPS) and the Rigidity Scale, we defined three groups: bipolar at-risk (n=42), unipolar at-risk (n=34), and control (n=37). All completed the d2 Test and the Continuous Performance Test (CPT). RESULTS: There was no evidence for overall attentional deficits in people at risk for affective disorders. However, reduced sensitivity, i.e., less discrimination between targets and nontargets, was observed in people at risk for bipolar disorders who also displayed schizotypy. LIMITATIONS: We only looked at selective and sustained attention and did not assess other factors such as memory or executive functions. Additionally, the risk status was only defined by a psychometric indicator and did not include other approaches of defining risk (e.g., first-degree relatives). CONCLUSIONS: Despite some limitations, our results support on one hand the idea that vulnerability for bipolar disorder can be associated with cognitive impairments, but they also highlight that this is not generally the case. Vulnerability for bipolar disorder and schizotypy might be correlated but are not the same.

Adolescent↗

PubMed2005

The HCL-32: towards a self-assessment tool for hypomanic symptoms in outpatients.

BACKGROUND: Bipolar disorders (BP) are frequently diagnosed and treated as pure depression initially; accurate diagnosis often being delayed by 8 to 10 years. In prospective studies, the presence of hypomanic symptoms in adolescence is strongly predictive of later bipolar disorders. As such, an instrument for self-assessment of hypomanic symptoms might increase the detection of suspected and of manifest, but under-treated, cases of bipolar disorders. METHODS: The multi-lingual hypomania checklist (HCL-32) has been developed and is being tested internationally. This preliminary paper reports the performance of the scale in distinguishing individuals with BP (N=266) from those with major depressive disorder (MDD; N=160). The samples were adult psychiatry patients recruited in Italy (N=186) and Sweden (N=240). RESULTS: The samples reported similar clinical profiles and the structure for the HCL-32 demonstrated two main factors identified as "active/elated" hypomania and "risk-taking/irritable" hypomania. The HCL-32 distinguished between BP and MDD with a sensitivity of 80% and a specificity of 51%. LIMITATIONS: Although the HCL-32 is a sensitive instrument for hypomanic symptoms, it does not distinguish between BP-I and BP-II disorders. CONCLUSIONS: Future studies should test if different combinations of items, possibly recording the consequences of hypomania, can distinguish between these BP subtypes.

Ambulatory Care↗

PubMed2005

Assessing the dysregulation of the Behavioral Activation System: the Hypomanic Personality Scale and the BIS-BAS scales.

We discuss the Hypomanic Personality Scale (Hyp; Eckblad & Chapman, 1986) and the Behavioral Inhibition System (BIS-BAS; Carver & White, 1994) and Behavioral Activation System (BAS; Gray, 1991) Scales as risk factors for bipolar disorders. The dysregulation of the BAS is considered to be central and results in higher variability in mood. Therefore, we examined how those scales are associated with mood fluctuations. A total of 59 participants completed a diary for at least 17 days. It included a modified Center for Epidemiologic Studies-Depression Scale (Meyer & Hautzinger, 2001) assessing depression and mania and the Positive and Negative Affect Schedule (Watson, Clark, & Tellegen, 1988). Hyp and BAS predicted levels of mania and of positive affect but also fluctuations of mania. Hyp also predicted instability of negative affect. Our data also suggest that mood variability is a trait-like feature. Both scales seem not to be perfect measures of the dysregulation factor. Future research should assess this dysregulation more directly.

Adolescent↗

PubMed2005

Are measures of hypomanic personality, impulsive nonconformity and rigidity predictors of bipolar symptoms?

OBJECTIVES: It has been suggested that temperaments such as 'hypomanic personality' (HYP) have an explanatory role in affective disorders. Similarly, the impulsive nonconformity scale, originally designed to assess psychosis proneness, was recently found to augment the prediction of manic episodes. Conversely, research indicates that 'rigidity', a central feature of Typus Melancholicus (TMEL; von Zerssen, 1996), may characterize the premorbid personality of depressives. DESIGN: The present study combines these three scales to prospectively predict manic and depressive symptoms diagnosed 2 years later in a non-college student population. METHOD: Structured clinical interviews for DSM-IV were conducted with 114 individuals (60% female, mean age = 19 . 9 years), 2 years after an initial screening. RESULTS: It was found that none of the predictors predicted purely depressive symptoms. As expected, HYP emerged as the strongest predictor of (hypo-)manic symptoms. CONCLUSIONS: While rigidity did not predict depression, people with a hypomanic temperament are at risk of developing symptoms of bipolar disorder, especially (hypo-)manic ones. It is noteworthy that this was evident in our young sample, still in the earlier stages of the high-risk period.

Adult↗

PubMed2004

Do child psychiatrists in Germany diagnose bipolar disorders in children and adolescents? Results from a survey.

OBJECTIVES: There is a controversy about the prevalence of childhood bipolar disorders (BD). Based on discrepant results, we studied if German psychiatrists in outpatient settings diagnose BD in children and adolescents at all, and if there are possible correlates of the diagnoses of pediatric BD. We also asked how often typical manic symptoms (e.g. elated mood) are actually seen in attention deficit hyperactivity disorder (ADHD) patients. METHODS: Provided by the medical register we had a complete list of all 251 psychiatrists in the area. Using a questionnaire we asked if and how often they diagnose BD among children and adolescents and how often they observe manic-like symptoms in children with ADHD (response rate 61%). RESULTS: While 63% of all psychiatrists have diagnosed BD in adolescents, only 7.8% did so in children. Age and therapeutic approach of the psychiatrists were associated with the likelihood of having diagnosed BD in children. Furthermore some typical bipolar symptoms were also present in ADHD patients. CONCLUSIONS: Our study only relied on self-reports of the psychiatrists about the diagnoses and number of cases, but BD in children seems to be rarely diagnosed in outpatient settings in Germany. The design of our study, however, cannot resolve the questions what the reasons are for this low rate of BD diagnoses, e.g. misdiagnoses, overlooking comorbidity or referral strategies. Epidemiological studies are needed and should consider multiple follow-ups.

Adolescent↗

PubMed2003

Screening for bipolar disorders using the Hypomanic Personality Scale.

INTRODUCTION: The Hypomanic Personality Scale (Hyp; Eckblad and Chapman, 1986) might be an indicator for the risk for bipolar affective disorders. We investigated whether the results with American samples can be replicated in a different sample. METHODS: The participants (N=224) completed a questionnaire package including the Hyp Scale and were independently interviewed with a psychiatric interview schedule. RESULTS: Compared to the control group, persons scoring high on the Hyp scale reported significantly more manic or hypomanic episodes but not episodes of major depression. Correspondingly, the risk group exceeded the control group only on the rate of bipolar affective disorders (20.8% vs. 1.3%) but not unipolar depression, anxiety disorders, or other psychiatric conditions. CONCLUSIONS: It seems that the Hyp scale assesses a similar concept in American and German samples, and that it might be a useful tool to study more closely the processes associated with the development of bipolar spectrum disorders.

Adult↗

PubMed2003

Is there evidence for a latent class called 'hypomanic temperament'?

BACKGROUND: Affective disorders belong to the most common psychiatric disorders. Several risk factors have been postulated and empirically investigated. Researchers like Akiskal [Interpersonal Factors in the Origin and Course of Affective Disorders, Gaskell, London, 1996] have pointed out the associations between sub-affective temperaments and affective disorders. However, no study has dealt with the issue whether there is a latent class of such sub-affective temperaments or if such temperaments are best conceptualized as fully dimensional. We investigated whether the Hypomanic Personality Scale [J. Abnorm. Psychol. 121 (1986) 214-222] as an indicator of hyperthymia is taxonic in structure. METHODS: We chose two different samples to address this issue: A sample of young adults (n = 1,966) and another sample of adolescents (n = 4,045). We ran MAXCOV-HITMAX analyses based on identical subsets of items in both samples. RESULTS: Neither in the sample of young adults nor in the sample of adolescents there was evidence for a latent class called 'hypomanic temperament'. LIMITATION: Only one indicator for vulnerability and one procedure to test for latent classes was used. Furthermore, we do not know how many of our sample had a life-time history or current affective disorders. CONCLUSIONS: The hypomanic-hyperthymic temperament is best conceptualized as a dimension in the general population. However, before drawing final conclusions about the taxonicity of the risk for affective disorders, more research is needed using different measures, samples and methods to resolve this question of the dimensionality of vulnerability. Additionally, the question remains open how to conceptualize mania itself.

Adult↗

PubMed2002

Prediction of personality disorder traits by psychosis proneness scales in a German sample of young adults.

Prior research has focused on schizophrenia-spectrum disorder traits in psychosis-prone subjects. The whole range of personality disorders were only explored in patient samples and with the relatives of patients. In light of this situation, the predictive value of Physical Anhedonia (PhA), Perceptual Aberration (PER), and Magical Ideation (MI) for personality disorder traits were examined dimensionally and categorically in a non-patient sample. We selected a non-student sample (n = 404) and focused on two risk groups (PhA: n = 14; combined PER/MI: n = 36), and a control group (n = 19) using the SCID II to assess personality disorders at a time period two years later. MI explained most of the variance in clinically relevant schizotypal personality disorder symptoms, while PER and PhA dimensionally were associated with the number of diagnostic criteria met for other personality disorders. While both risk groups exceeded the control group in clinically relevant borderline traits, only the PER/MI-individuals differed in fulfilling more criteria for schizotypal personality disorder.

Adolescent↗

PubMedDate not supplied

No evidence for verbal memory impairment in individuals putatively at risk for bipolar disorder.

BACKGROUND: Hypomanic temperament and rigid personality are putative risk factors for affective episodes and even bipolar disorder. Individuals with bipolar disorder exhibit neuropsychological impairments, especially memory difficulties, not only during mood episodes but also when they are euthymic. Such cognitive impairments may also constitute a risk factor for bipolar disorder. The purpose of the present study was to investigate the presence of memory difficulties in individuals with hypomanic and rigid personality traits. METHODS: Study participants were 6000 German students recruited from high schools, colleges, and vocational schools in Germany. The students completed the Hypomanic Personality Scale and the Rigidity subscale of the Munich Personality Test. Four groups of students were selected from this sample based on their scores in the Hypomanic Personality Scale and Rigidity subscale: individuals with (1) hypomanic temperament, (2) rigid temperament, or (3) hypomanic-rigid temperament and (4) control participants. These students (n = 153) completed the Rey-Auditory Verbal Learning Test, a well-established measure of verbal learning and memory, as well an IQ test (Leistungsprüfsystem). RESULTS: Multiple regression analyses indicated that sex and IQ, but not temperament, predicted learning of the Auditory Verbal Learning Test word list, the number of words recalled at short-delayed recall, and recognition. LIMITATIONS: The risk for affective disorders was only defined by psychometric measures, and we did not control for family history of bipolar disorders. CONCLUSIONS: Hypomanic temperament and Rigid personality were not associated with verbal learning and memory. Cognitive impairment may be associated with repeated mood episodes rather than constituting a risk factor for bipolar disorder.

Adolescent↗

PubMedDate not supplied

The structure of affective symptoms in a sample of young adults.

Symptoms of bipolar disorders include depression and mania. The term "bipolar" implies states that are opposite to each other. Construing scales that define mania and depression as opposite ends of one dimension cannot account for the existence of mixed symptoms. One self-report instrument, the Internal State Scale (ISS), combines both dimensions in one measure. However, the ISS only assesses internal subjective states and does not tap other typical and more objective symptoms of (hypo-) mania. To explore the factorial structure of affective symptoms in a general population sample, we extended the Center for Epidemiologic Studies-Depression Scale (CES-D), adding items to assess manic symptoms as described in DSM-IV. The scale was completed by 2,059 young adults. The results for the original CES-D are comparable to prior studies. Factor-analysis for the extended CES-D revealed two factors in women and men: most manic symptoms loaded high on a factor "euphoria-activation," whereas the other factor included all typical dysphoric-depressive symptoms, but also included the "manic symptoms" of distractibility and irritability. Our results support a two-factor model of bipolar symptoms in the general population with irritability being more closely associated with dysphoria than euphoria. The implications and limitations of the present results are discussed.

Adolescent↗