Archives Of General Psychiatry Research Articles

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

Cross-cultural validation of the revised Temperament and Character Inventory: Serbian data

Objective In this work, we report data on construct validity and cross cultural applicability of the revised Temperament and Character Inventory (TCI R) (Cloninger, C.R., Przybeck, T.R., Svrakic, D.M., & Wetzel, R.D. (1999). The Temperament and Character Inventory-revised, Washington University, St. Louis), a 5-point scale scoring formatrevision of the original, true-false version TCI (Cloninger, C.R., Przybeck, T.R., Svrakic, D.M., & Wetzel, R.D. (1994). The Temperament and Character Inventory-A guide to its development and use, Washington University, St. Louis). Both versions are based on the seven factor Psychobiological Model of Personality (Cloninger CR, Svrakic, DM & Przybeck TR (1993). A Psychobiological Model of temperament and Character, Archives of General Psychiatry, 50, 975-990). Methods The sample consisted of 473 normal adult subjects representing a number of Serbian cities and towns, recruited consecutively while registering at the National Employment Center, located in Belgrade, Serbia. The sample was the designed to be highly representative of urban and suburban population in Serbia to match to TCI R sample in the US. The 240-item, 5-point scale scoring TCI R was used to assess temperament and character traits. In addition to a number of other revisions, the scoring format in the TCI R was changed into a 5-point Likert scale to increase its sensitivity to subtle variations in personality expression. The TCI R mean scores and standard deviations were compared between Serbian and US subjects, internal consistency of the TCI R scales was estimated using Cronbach's alpha coefficients, and principal component analysis was used separately for temperament and character (because of their non-linear relationship) to test the underlying factorial structure of the TCI R. Parallel analysis and randomized simulation data were used to determine the number of factors for temperament and character. Results The results generally supported the construct validity and the cross cultural applicability of the TCI R in Serbia. With a few exceptions, the observed internal consistency for the TCI R scales was acceptable. For the most part, the US and Serbian subjects manifested comparable temperament traits, whereas US subjects had higher character scores. The observed differences are understood as partly reflective of local culture and partly of dramatic socio-economic change in Serbia over the last 20 years. Principal component analysis fully supported the four factor structure of temperament and the three factor structure of character, as postulated by theory. The inadequacy of using linear statistical methods in studying complex non-linear systems such as personality is discussed in some detail.

P02-221 - The “gender gap” in authorship of academic psychiatric literature

ObjectiveThe number of women in psychiatry has increased considerably during the past 40 years, but issues of concern persist regarding the advancement of women in academic medicine. The study explores the development of the representation of women among authors of scientific publications.MethodArticles published by three high impact general psychiatric journals - the Archives of General Psychiatry, the American Journal of Psychiatry and the British Journal of Psychiatry - were categorized according to characteristics of psychiatric research with respect to the researchers’ gender. Data were collected for the years 1994 and 2007.ResultsOverall the rate of female authors increased from about one fourth in 1994 to one third in 2007. The highest increases of female authors were found in the most relevant areas for academic career: first authorship, original research articles and publications on neuroimaging and genetics.ConclusionsDespite considerable gains, women still compose a minority of authors of scientific publications in the journals studied. Ongoing effort and interventions are required to promote further advances and gender equity.

Mental Illness Prevention Finally Gets Support From Science

Mental Illness Prevention Finally Gets Support From Science

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

Understanding and Treating Unwanted Trauma Memories in Posttraumatic Stress Disorder

Distressing and intrusive reexperiencing of the trauma is a hallmark symptom of posttraumatic stress disorder (PTSD; American Psychiatric Association, 1994). However, unwanted memories of trauma are not a sign of pathology per se. In the initial weeks after a traumatic experience, intrusive memories are common. For most trauma survivors, intrusions become less frequent and distressing over time. A central question for understanding and treating patients with PTSD is therefore what maintains distressing intrusive reexperiencing in these people. Three factors appear to be important: (1) memory processes responsible for the easy triggering of intrusive memories, (2) the individuals’ interpretations of their trauma memories, and (3) their cognitive and behavioral responses to trauma memories.

Disclosure in Biographically-Based Fiction: The Challenges of Writing Narratives Based on True Life Stories

Disclosure in Biographically-Based Fiction: The Challenges of Writing Narratives Based on True Life Stories

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

The structure of mental disorders re‐examined: Is it developmentally stable and robust against additions?

Previous research suggests that patterns of comorbidity of a limited number of anxiety, depressive, substance use and antisocial personality (ASP) disorders among adults are best reflected by a hierarchical three-factor structure with two correlated factors ('anxious-misery' and 'fear') that are summarized in a second-order 'internalizing' factor and one 'externalizing' factor. It has not been examined whether this structure is developmentally stable and robust against additions of more diagnoses. Using data from a prospective-longitudinal community study of adolescents and young adults we re-evaluate the three-factor model originally proposed by Krueger (Archives of General Psychiatry, 1999; 56, 921-926). Using confirmatory factor analysis with identical conventions as in Krueger's original work we found that the three factor model did not fit robustly across age or a wider range of diagnoses. Using explanatory factor analysis we examined alternative structures. We found various clinically meaningful patterns with good fit that go substantially beyond the original three-factor structure. However, again, there is little consistency in findings when different age groups or different diagnoses are considered. Our findings suggest that psychopathology cannot be reduced to any simple structure.

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

Making sense of autism. T. Thompson. Brookes, Baltimore, London, 2007. pp. 280. Price: US$26.99; £21.95. ISBN 9781557669155.

Infant and Child DevelopmentVolume 18, Issue 4 p. 372-374 Book ReviewFree Access Making sense of autism. T. Thompson. Brookes, Baltimore, London, 2007. pp. 280. Price: US$26.99; £21.95. ISBN 9781557669155. Elizabeth Pellicano, Elizabeth Pellicano Department of Experimental Psychology, University of Bristol, UKSearch for more papers by this author Elizabeth Pellicano, Elizabeth Pellicano Department of Experimental Psychology, University of Bristol, UKSearch for more papers by this author First published: 22 July 2009 https://doi.org/10.1002/icd.606AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. References Charman, T., Taylor, E., Drew, A., Cockerill, H., Brown, J. A., & Baird, G. (2005). Outcome at 7 years of children diagnosed with autism at age 2: Predictive validity of assessments conducted at 2 and 3 years of age and pattern of symptom change over time. Journal of Child Psychology and Psychiatry, 46, 500– 513. Dawson, G., Webb, S. J., & McPartland, J. (2005). Understanding the nature of the face processing impairment in autism: Insights from behavioral and electrophysiological studies. Developmental Neuropsychology, 27, 403– 424. Frith, U. (1989). Autism: Explaining the enigma. Oxford, UK: Blackwell Publishers. Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217– 250. Lord, C., Risi, S., DiLavore, P., Shulman, C., Thurm, A., & Pickles, A. (2006). Autism from two to nine. Archives of General Psychiatry, 63, 694– 701. Mottron, L., Dawson, M., Soulières, I., Hubert, B., & Burack, J. (2006). Enhanced perceptual functioning in autism: An update, and eight principles of autistic perception. Journal of Autism and Developmental Disorders, 36, 27– 43. Pellicano, E., Maybery, M., Durkin, K., & Maley, A. (2006). Multiple cognitive capabilities/deficits in children with an autism spectrum disorder: ‘Weak’ central coherence and its relationship to theory of mind and executive control. Development and Psychopathology, 18, 77– 98. Tager-Flusberg, H. (2007). Evaluating the theory of mind hypothesis. Current Directions in Psychological Science, 16, 311– 315. Volume18, Issue4July/August 2009Pages 372-374 ReferencesRelatedInformation

The contribution of anxiety and depression to fatigue among a sample of Australian university students: suggestions for university counsellors

Responses to the Zung Self-Rating Anxiety Scale (SAS: Zung, W. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12, 371–379), the Self-Rating Depression Scale (SDS: Zung, W. (1973). From art to science: The diagnosis and treatment of depression. Archives of General Psychiatry, 29, 328–337) and the Fatigue Severity Scale (FSS) developed by Krupp and colleagues (Krupp, L.B., LaRocca, N.G., Muir-Nash, J., & Steinberg, A.D. (1989). The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology, 46, 1121–1123) were collected from 200 Australian university students to explore the links between these three disorders. Reliability data were satisfactory for all three scales and there were no significant gender or age-related differences between total scale scores. Factor analyses revealed a 5-factor solution for the SAS, a 6-factor solution for the SDS and a single factor for the FSS. There were 8 major and meaningful correlations found and these were entered into a regression of the SAS and SDS factor scores upon the single factor of the FSS. Fatigue factor scores were most powerfully predicted by psychomotor agitation, pain and resultant fatigue and cognitive and emotional arousal factor scores from the SAS and SDS. These data argue for an arousal/anxiety-fatigue-depression progression in disease that may be developmental or accumulative, with extreme levels of psychomotor arousal, resultant muscle fatigue and pain, plus concurrent elevated emotional state and cognitive arousal contributing to an eventual depletion of physical resources, leaving the individual in extreme fatigue. Implications for diagnosis and treatment by counsellors are discussed.

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

Commentary: Explaining enormous variations in rates of disorder in trauma-focused psychiatric epidemiology after major emergencies

There has been a surge of interest in the last 20 years in the mental health effects of conflict and other major disasters in lowand middle-income countries (LAMIC). In particular, post-traumatic stress disorder (PTSD) and major depression have received substantial attention. It has become evident that there are large, unexplained variations in prevalence rates identified through trauma-focused psychiatric epidemiology in such settings. For example, Mollica et al.’s classic study found prevalence rates of PTSD of 15% among genocide-exposed Cambodians, while Neugebauer et al.’s sophisticated report in this issue of the Journal identifies rates of 53–62% of PTSD in genocide-exposed Rwandans. The wide variation in the prevalence rates in studies of PTSD and depression may be attributable to differences in context, methodology or both. Discussion sections of reports often highlight only a few factors that could explain the size of obtained rates. Although peer review helps shape discussion sections, authors usually have enormous discretion in deciding what factors to report. Readers are left with the challenge of tracking all reported and unreported methodological and contextual factors that could explain a study’s results. We have developed a scheme that may help to systematically identify factors influencing the size of observed prevalence rates of disorders in populations affected by major emergencies in LAMIC. The scheme may prove useful for readers and journal peer reviewers alike. The scheme, which we will apply below to Neugebauer et al.’s study, was built as follows. We searched the following medical, psychiatry and speciality journal websites: American Journal of Psychiatry; Archives of General Psychiatry; British Journal of Psychiatry; British Medical Journal; Culture Medicine and Psychiatry; JAMA, Journal of Traumatic Stress, Lancet, Psychological Medicine; Social Science and Medicine; and Transcultural Psychiatry for studies published after 1998 with data collected on depression or PTSD among civilians after major emergencies in LAMIC (references available upon request). Of 43 studies, 11 (26%) pertained to major natural disasters and 32 (74%) pertained to major human-made disasters (e.g. war). All articles were original contributions, and 40 (93%) made comments explaining the magnitude of findings in the articles’ discussion sections. In addition, we reviewed editorials, commentaries and letters to the editor linked to the identified articles. We thematically analysed discussion sections of all papers. We categorized authors’ explanations for observed rates as (i) either methodological or contextual in nature and (ii) explaining either relatively higher or lower observed rates. In addition, we categorized some explanations as (iii) reflecting general methodological limitations causing uncertainty in the validity of the study, with unknown impact on the magnitude of observed rates. Table 1 provides an overview of the explanations for relatively high or low rates ascribed in these studies. We studied the research reported in this issue of the Journal and rated different methodological and contextual factors in the study from 1 (not a factor in explaining size of obtained rate) to 5 (definitive factor in explaining size of obtained rate) (see bracketed numbers in Table 1). If no information was available in the paper on an element, then we rated it 3. Starting with the cell in the bottom left, we will discuss here ratings of 4 and 5, which are of main interest in explaining findings. The study took place in 1995 in a context (recent genocide that was preceded and followed by violence, fears of revenge killings, ongoing mass displacements, risk of cholera outbreaks, etc.) that not only involved mass loss and trauma but also a highly stressful recovery * Corresponding author. Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland. E-mail: vanommerenm@who.int 1 Faculty of Medicine, University of Toronto, Toronto, Canada. 2 Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland. Published by Oxford University Press on behalf of the International Epidemiological Association

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry

This Month in Archives of General Psychiatry