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Psychosocial factors and the development of breast cancer: a meta-analysis.

A meta-analysis examined the relationship between psychosocial factors and the development of breast cancer. Average effect sizes (Hedges's g) were calculated from 46 studies for 8 major construct categories: anxiety/depression, childhood family environment, conflict-avoidant personality, denial/repression coping, anger expression, extraversion-introversion, stressful life events, and separation/loss. Significant effect sizes were found for denial/repression coping (g = .38), separation/loss experiences (g = .29), and stressful life events (g = .25). Although conflict-avoidant personality style was also significant (g = .19), the effect size was less robust, and a moderate number of future studies with null results would reduce the significance. Results overall support only a modest association between specific psychosocial factors and breast cancer and are contrary to the conventional wisdom that personality and stress influence the development of breast cancer.

Adaptation, Psychological↗

Twelve blood markers and measures of temperament.

This project tested the association of 12 blood marker systems with the Eysenck Extraversion-Introversion/Neuroticism forms and the Buss-Plomin Temperament forms. The sample was about 400 males and 470 females who were given medical examinations during the Tecumseh Community Health Study (Michigan). ANOVA and Scheffe tests were used to test for significant differences; personality traits were adjusted for age. The Lewis red blood cell phenotypes were significantly associated with Anger and Impulsivity for males and Sensation-seeking (a subscale of Impulsivity) for females. It is suggested that these temperament factors merit further exploration.

Blood Group Antigens↗

Personality traits and stress sensitivity in migraine patients.

A review of the literature on migraine and personality yielded strong evidence for secondary neuroticism and increased sensitivity to stress in patients with migraine. This study focused on the identification of specific stressful situations and coping strategies in such patients. We conducted a psychodiagnostic study of 30 migraine patients in accordance with the criteria of the Headache Classification Committee of the International Headache Society and 30 healthy control subjects matched for age, sex, and social status. All participants completed the Minnesota Multiphasic Personality Inventory (MMPI) and special questionnaires on stressful situations and coping strategies. The migraine patients had higher neuroticism and introversion scores on the MMPI than the healthy subjects. There was a positive correlation between the neuroticism score and headache duration (number of hours per week). The patients used coping strategies characterized by the development of physical symptoms, social isolation, and preoccupation with stress. They rated themselves as less calm, less capable of relaxing, and more irritable than did the healthy controls subjects, and they responded more often with internal tension, especially in work and other achievement situations. Questionnaires that measure constructs dealing with stress yield information that is more relevant for the treatment of migraines than do global personality tests.

Adaptation, Psychological↗

Lymphocyte response to mitogens: influence of life events and personality.

The aim of the present study was to examine the possibility that the accumulation of life events is associated with low lymphoproliferative response to mitogens in undergraduate students. We also analyzed the possible interaction between life events and personality traits. Lymphocyte response to phytohemagglutinin (PHA) was lower in subjects with high life events compared to those with low levels. Introverted subjects were found to exhibit lower lymphocyte responses to PHA than those who were extraverted, and there was no interaction between the effect of introversion and life events on the proliferative capacity. Lymphocyte proliferation was low in subjects with high anxiety scores, whether they had high or low levels of life events. In the group with high scores on independence a high accumulation of life events was not associated with lower lymphoproliferation; while in the group with low scores it was, suggesting that independence buffers the association between life stress and lower cellular immunity.

Adolescent↗

Rethinking communication apprehension: a Myers-Briggs perspective.

This study is an examination of relationships between Myers-Briggs personality type preferences, based on Jungian theory, and communication apprehension. Results showed that participants who preferred introversion or sensing reported significantly higher levels of communication apprehension in general and across the group, dyadic, meeting, and public contexts than did participants who preferred extraversion or intuition. In addition, participants who preferred feeling reported higher levels of communication anxiety in the public context than those who preferred thinking. Findings support the assumption that communication apprehension is biologically based, suggest that the Myers-Briggs type preference framework offers an alternative way of understanding communication apprehension, and point out the need for new approaches to understanding the phenomenon of communication apprehension.

Adult↗

Coping, treatment planning, and treatment outcome: discussion.

The articles presented in this issue are discussed within the context of the general literature on coping and coping style. The focus of this special issue was to determine if these articles are both consistent with extant research and advance the field. We identify at least two general definitions of coping, as used in these articles. We refer to one definition as reflecting one's "coping style." This is largely a descriptive concept and closely related to one's enduring behavioral traits. It is closely related to other personality characteristics such as introversion-extroversion, stability, etc. The other definition of "coping" in the literature is much more specific to stressful environments and to the changes noted in one's behavior and cognitions during times of stress, than the first definition. We refer to this broad stress response as one's "coping response." Coping response, unlike coping style, includes both a cognitive and an affective component. We conclude that it may be advantageous to differentiate between these two broad definitions in future research. We also conclude that the articles in this issue provide information that advances the field's understanding of coping styles and coping responses.

Adaptation, Psychological↗

Personality and anxiety in temporomandibular joint syndrome patients.

Much research has suggested that anxiety is involved in the temporomandibular joint syndrome (TMJ), but it is not clear whether it is a cause or a consequence of the disorder. The present study attempts to resolve this issue. Thirty-two patients suffering from temporomandibular joint syndrome and 32 sex- and age-matched dental clinic controls completed the Spielberger State-Trait Anxiety Inventory, the Eysenck Personality Questionnaire and a standardized inventory of bodily symptomatology. TMJ patients scored significantly higher on Eysenck's neuroticism and introversion scales (both P less than 0.05) and had higher trait anxiety scores (P less than 0.005) when compared with controls. These results suggest that TMJ patients have personalities that are vulnerable to life stresses, but that they are not more anxious than controls at any given time. Such a personality profile is similar to that found in other 'functional' syndrome patient groups, such as individuals with globus pharyngis. We suggest that certain stress prone personalities express anxiety in the form of a predictable set of physical syndromes which may be subject to changes with time.

Adult↗

Dispositional correlates of addictive behaviors in college women: binge eating and heavy drinking.

Binge eating and alcohol abuse are often conceptualized as addictive behaviors. As these behaviors are relatively common among undergraduate college women, we examined whether common dispositional variables underlie their occurrence. Three hundred and thirty-five undergraduate women completed self-report questionnaires about their eating and alcohol use habits as well as dispositional measures of impulsivity, tolerance of deviance, self-esteem, rejection sensitivity, extraversion-introversion, conscientiousness, and emotional stability. Multiple regression analyses showed that women who either binge eat or abuse alcohol, but not both, have similar dispositional characteristics. Both groups exhibited a high degree of impulsivity and endorsed socially deviant attitudes; thus, both groups could be viewed as "externalizers." In contrast, women who admitted to both addictive behaviors, i.e., binge eating as well as alcohol abuse, were not particularly impulsive or socially deviant, but manifested a high degree of emotional instability ("neuroticism"); thus, these women might be considered "internalizers." The theoretical and clinical implications of these findings are discussed.

Adolescent↗

[The pre-morbid personality of schizophrenics in the literature of the last hundred years (author's transl)].

A survey of the literature on the primary personality of schizophrenics shows that the essential concepts derive from Kraepelin (1893), E. Bleuler (who also introduced the technical term "schizoid", 1911) and C.G. Jung introversion; 1913). E Kretschmer (1921) adopted these preliminary findings and integrated them into his system of "Constitution" which greatly stimulated research in this field. Most of the following investigations confirmed his hypotheses on the basis of clinical impressions. A few only criticised his teaching, particularly as a theoretical concept. The musculo-somatotonic type apart, Sheldon's (1940) research agrees with Kretschmer to a large degree. Later investigators, however, could not sufficiently support Sheldon's constitutional biology on empirical grounds. No further pre-morbid types were developed in the following years, if one discards the somewhat rare "stormy" character (Arieti, 1955). All attempts to discover differences between the pre-morbid development of personality and the subheadings of schizophrenia failed. Pre-morbid sexual development is not typical, but the disturbances of contact are in the foreground. Whether schizophrenics differ later in their intelligence is still undecided. But it appears certain that, even before the start of their illness, they achieve a lower social status than their siblings. There exists a large experimental psychologic literature on relationships between the original personality, symptoms and psychophysiologic correlates in which it is confirmed again and again that bad pre-morbid adaptation corresponds closely with the severity of symptoms and loss of achievement. There are no consonant result of investigations into the frequency of schizoid structures in schizophrenics, in psychiatric control groups and in the normal population. Psychometric techniques have been used only rarely, but existing publications confirm in principle that schizophrenics are markedly more schizoid than control groups. As with schizophrenia, there are contrasting ideas as to the cause and pathogenesis of the pre-morbid personality. Psycho- and socio-genetic, behavioral, genetic and neurochemical hypotheses have their adherents. According to recent studies of adoption the genetic factor appears to predominate. The clinician relies on pre-morbid development of the personality in his search for a "kink in the life line" or in his assessment of the quality of remissions. There is general agreement that a schizoid primary personality has an unfavorable influence on the long-term prognosis. This is still true today, in spite of modern possibilities of treatment and rehabilitation. Prophylactic aspects have been discussed for a long time but have remained unhelpful clinically. Often it may be difficult to distinguish between schizoids and mild hebephrenias. In spite of this the clinical concept "schizoid" should never be used for "mild schizophrenia"...

Adoption↗

Reinforcement sensitivity, coping, and delinquent behaviour in adolescents.

Since 1964, the relationship between personality and criminal behaviour has been extensively studied. However, studies, which have examined the Eysenckian dimensions of extraversion, neuroticism and psychoticism have produced mixed results. Gray's [Gray, J. A. (1970). The psychophysiological basis of introversion-extroversion. Behavior Research and Therapy, 8, 249-266] Reinforcement Sensitivity Theory provides an alternative conceptualisation of the role of personality in criminal behaviour, and has generally produced more consistent findings. This study aimed to examine the relationship between reinforcement sensitivity and delinquent behaviour in a sample of 259 adolescents, and to examine the role that coping strategies play in this relationship. Hierarchical regression analyses revealed that use of problem solving mediated the relationship between reward sensitivity and delinquent behaviour, while use of non-productive coping strategies moderated the relationship between BAS drive and delinquency. Consequently, it was suggested that coping skills training could be an effective early intervention for delinquent behaviour.

Adaptation, Psychological↗

The non-evaluative circumplex of personality adjectives.

In judgments about personality, descriptive and evaluative aspects are ordinarily combined; separating them can be important both theoretically and practically. Study 1 showed that two similar descriptive factors can be found in analyses of personality terms, selected independently in English and in German and using different methods to control for evaluation. The factors relate to two pairs of independent axes suggested by previous work: Assertive-Unassertive and Tight-Loose, or alternatively, Interactional Orientation (Extraversion-Introversion) and Affective Orientation. These two pairs of axes are shown to be rotations of each other, and to form the prime non-evaluative circumplex. As in previous studies, non-evaluative scales elicited higher levels of self-peer agreement than did more typical evaluation-confounded scales. Study 2 showed that adjective scales for the octants of this circumplex have circular ordering, can fit even very stringent constraints of a circumplex model, have mild to strong isomorphism with the interpersonal circumplex, but represent somewhat broader constructs, and are systematically related to the Big Five and the Big Three personality factors.

Factor Analysis, Statistical↗

How valid are the subscales of the Multiscore Depression Inventory?

Investigated subscales of the Multiscore Depression Inventory for construct and concurrent validity. A hierarchical cluster analysis based on the responses of 263 students provided support for the construct validity of Irritability, Energy Level, Guilt, Instrumental Helplessness, Social Introversion, and Cognitive Difficulty. The separation of Low Self-Esteem and Pessimism was supported only partially, while Learned Helplessness and Sad Mood combined in a single cluster. The graph-theoretic advantages of the cluster analysis permitted speculation about the relationship among the subscales. Factor-analytic examination of the same data demonstrated comparable evidence of construct validity for most scales. Concurrent validity was demonstrated on a sample of 89 students, with significant relationships obtained for all subscales with respective criterion measures, with the exception of Learned Helplessness, which had a low, but significant, correlation with its criterion. Discriminant validity was demonstrated by low correlations between the subscales and socially desirable responses.

Depressive Disorder↗

Extroversion, anxiety and the perceived effects of alcohol.

To test the hypothesis that personality characteristics are related to alcohol-effect expectancies, 256 (115 men) college students were divided into groups on the basis of self-reported alcohol consumption and anxiety and introversion scores on the Sixteen Personality Factor Questionnaire. Three-way multivariate analyses of variance were conducted to determine expectancy differences by drinking behavior, personality characteristics and sex. Alcohol expectancy scores were found to vary with drinking behavior and personality measures. Elevated expectancy scores were associated with higher quantity-frequency measures of drinking; however, no significant sex differences were obtained. Extroverted students expected more social and physical pleasure, more relaxation and less arousal with drinking. Students with higher levels of trait anxiety expected more global positive changes, sexual enhancement, social assertion and arousal. The association of drinking behavior and personality with expectancies appears to be independent and additive.

Adolescent↗

Impaired smooth pursuit eye movement: vulnerability marker for schizotypal personality disorder in a normal volunteer population.

Impaired smooth pursuit eye movement has been proposed as a possible biologic marker for schizophrenia. Preliminary studies have suggested that this impairment may be associated with social introversion and related psychopathology in a nonpsychiatric population. To evaluate the relationship between dysfunctional smooth pursuit eye movement and schizophrenia-related psychopathology, the authors screened a new, volunteer sample of 284 male college students for eye tracking accuracy. Volunteers identified as low-accuracy trackers were significantly more likely to be diagnosed (blindly) as having a schizotypal personality disorder by DSM-III criteria than those identified as high-accuracy trackers. The authors suggest that disordered smooth pursuit eye movement may reflect a vulnerability marker for schizotypal personality disorder.

Adult↗

Prediction of treatment-seeking behavior in acute TMD patients: practical application in clinical settings.

AIMS: To determine potential differences in predictive models of acute temporomandibular disorder (TMD) patients divided into groups based on the physiologic characteristics of their TMD. METHODS: One hundred seventy-seven acute TMD patients were evaluated with an extensive battery that included biologic and psychosocial measures. Subjects were separated into 3 groups based on a physical exam using the Research Diagnostic Criteria for TMD (RDC): those with a myofascial pain diagnosis, those with either a disc displacement or other joint condition, and those who reported pain but did not receive an RDC Axis I diagnosis. Six months later, it was determined whether patients had sought additional treatment for relief of their symptoms. Treatment-seeking and non-treatment-seeking groups were compared for significant differences, and predictive models were generated to determine the array of variables that best predicted treatment-seeking behavior among each of the 3 classifications of TMD patients used in this study. RESULTS: Among patients with a diagnosis of myofascial pain, gender, Multidimensional Pain Inventory (MPI) interference score, and MPI affective distress score accurately predicted treatment-seeking behavior in 76.1% of the sample. For patients with a diagnosis of disc displacement, arthralgia, arthritis, or arthrosis, the following variables predicted treatment utilization behavior in 93.6% of the sample: race, RDC graded chronic pain, and the introversion scale of the Minnesota Multiphasic Personality Inventory-2. For patients with no RDC Axis I disorder, 80.5% of the sample was accurately classified with regard to treatment-seeking behavior through the use of only the characteristic pain intensity score (i.e., mean of visual analog scale scores for "pain right now," "worst pain," and "average pain"). CONCLUSION: The factors that predict which acute TMD patients are most likely to seek additional treatment vary depending on the physiologic basis of their TMD. This suggests that acute TMD patients may benefit from different modalities of treatment, depending on the type of TMD with which they present.

Acute Disease↗

The factorial structure of schizotypy: Part I. Affinities with syndromes of schizophrenia.

A replication is reported of a three-factor--active, withdrawn, unreality--structure of schizotypy measured with the Schizotypal Personality Questionnaire (SPQ) in the normal population, a structure which has close affinities with a three-syndrome model of schizophrenia. Cognitive asymmetry patterns and arousal scales are found in the companion report--Part II in this issue of the Schizophrenia Bulletin. Here the withdrawn factor--loneliness and constricted affect--was also complemented by the physical anhedonia scale. The original sample (1995) was then combined with the replication sample to examine associations with the dimensions of extraversion-introversion, neuroticism, and psychoticism. Introversion loaded on the first withdrawn factor. The second unreality factor--unusual perceptions, magical beliefs, and ideas of reference--was unrelated to the Eysenck dimensions. Psychoticism loaded on the third active factor--eccentricity and odd speech. Neuroticism formed a fourth, nonspecific factor with social anxiety and suspiciousness. Insufficiencies in current measures of the structure of schizotypy and schizophrenia are discussed. These include the absence of activity-arousal from the SPQ, the limited assessment of cognitive disorganization in schizotypy, and its heterogeneity in schizophrenia. The history of the active-withdrawn classification and its importance in further elucidation of schizotypy and schizophrenia are outlined.

Adult↗

Extraversion and vigilance performance: 30 years of inconsistencies.

Deteriorating efficiency in detecting critical events is a pervasive phenomenon. It has been asserted that the personality dimension of extraversion-introversion (E-I) could serve as a selection device: Introverts would be superior in sustained attention. A meta-analysis revealed better performance of introverts, but the effect size was small because of a high incidence of inconsistencies. In a subset of the studies, the effect size was much larger: Introverts were superior in overall level of correct detections but not in maintaining efficiency over time. Inconsistent findings may partly have been caused by inappropriate use of univariate analysis of variance in repeated measures designs. The validity of some "classic" findings in the vigilance literature was questioned. The relationship of E-I to electrodermal speed of habituation was discussed. Finally, here also a trend was noted to move to new problems before solving old ones.

Arousal↗

The heterogeneous pain personality: diverse coping styles among sufferers of chronic pain.

The utility of personality assessment in chronic pain populations can be greatly enhanced with the understanding of risk assessment and the heterogeneous nature of at-risk personality types. Simplistic, unidimensional notions of risk have not been useful in assessing psychosocial and functional impairment in those with chronic pain syndromes. Previous literature suggests that certain combinations of psychometric scales, as opposed to individual scales, may be more useful in predicting the multiplicity of factors associated with functional disability among chronic pain patients. A hierarchical cluster analysis was performed on the 8 coping scales of the Millon Behavioral Health Inventory. Analyses revealed 3 distinct groups. The first cluster, termed repressors, exhibited high introversive and cooperative scales, and low forceful scales. The second cluster, termed amplifiers, exhibited high inhibited and sensitive scales. The third cluster, termed social copers, exhibited high confident and social scales. Analyses of these 3 clusters with regard to measures of psychopathology (Minnesota Multiphasic Personality Inventory II), depression (Beck Depression Inventory), functional impairment (Chronic Illness Problem Inventory), and other measures (Multidimensional Pain Inventory) resulted in significantly different levels of psychosocial and functional impairment. These clusters identified those patients who are at risk for nondisclosure of psychosocial dysfunction, those who are most emotionally distressed, and those who are most likely to comply with treatment. Consequently, such classifications identify psychosocial variables that will dictate a differential treatment approach and thus have potentially important clinical applications.

Adaptation, Psychological↗