Personality Distress Research Articles

Understanding the distressed prostate cancer patient: Role of personality.

To evaluate the relationship between personality and emotional distress in prostate cancer. Neuroticism and introversion were hypothesized to be associated with clinically significant symptoms of emotional distress, including depression, anxiety, and suicidal ideation. Men with a history of prostate cancer (n=212) completed an NIH-funded cross-sectional study using well-validated measures of personality, depression, anxiety, and suicidal ideation. Covariates were age, education, time since diagnosis, comorbidity, and presence of metastases. Emotional distress was reported by 37% of participants, including depression (23%), anxiety (15%), and suicidal ideation (10%). As hypothesized, men who were more neurotic were more likely to report emotional distress (44.5% vs 26.9%; OR=2.78, P=.004), depression (31.9% vs 11.8%; OR=4.23, P=.001), and suicidal ideation (29.4% vs 9.7%; OR=4.15, P=.001). Introverts were more likely to report emotional distress (45.2% vs 28.7%; OR=2.32, P=.012) and depression (30.8% vs 15.7%; OR=2.57, P=.014). Men with metastases were more likely to report emotional distress (51.7% vs 31.2%; OR=4.56, P<.001). Neuroticism and introversion were associated with clinically significant emotional distress in men with prostate cancer. Findings suggest that, in the context of treatment for prostate cancer, patient distress reflects disease characteristics (eg, metastases presence) as well as stable personality traits. Implications for clinical care are discussed.

Pathological grooming: Evidence for a single factor behind trichotillomania, skin picking and nail biting.

Although trichotillomania (TTM), skin picking (SP), and nail biting (NB) have been receiving growing scientific attention, the question as to whether these disorders can be regarded as separate entities or they are different manifestations of the same underlying tendency is unclear. Data were collected online in a community survey, yielding a sample of 2705 participants (66% women, mean age: 29.1, SD: 8.6). Hierarchical factor analysis was used to identify a common latent factor and the multiple indicators and multiple causes (MIMIC) modelling was applied to test the predictive effect of borderline personality disorder symptoms, impulsivity, distress and self-esteem on pathological grooming. Pearson correlation coefficients between TTM, SP and NB were between 0.13 and 0.29 (p < 0.01). The model yielded an excellent fit to the data (CFI = 0.992, TLI = 0.991, χ2 = 696.65, p < 0.001, df = 222, RMSEA = 0.030, Cfit of RMSEA = 1.000), supporting the existence of a latent factor. The MIMIC model indicated an adequate fit (CFI = 0.993, TLI = 0.992, χ2 = 655.8, p < 0.001, df = 307, RMSEA = 0.25, CI: 0.022–0.028, pclose = 1.000). TTM, SP and NB each were loaded significantly on the latent factor, indicating the presence of a general grooming factor. Impulsivity, psychiatric distress and contingent self-esteem had significant predictive effects, whereas borderline personality disorder had a nonsignificant predictive effect on the latent factor. We found evidence that the category of pathological grooming is meaningful and encompasses three symptom manifestations: trichotillomania, skin picking and nail biting. This latent underlying factor is not better explained by indicators of psychopathology, which supports the notion that the urge to self-groom, rather than general psychiatric distress, impulsivity, self-esteem or borderline symptomatology, is what drives individual grooming behaviours.

Personality, health behaviors, and quality of life among colorectal cancer survivors: Results from the PROFILES registry

ABSTRACTPurpose: There is a paucity of research looking into the relationship between personality and health behaviors among cancer survivors. The aim of this study was to investigate whether Type D personality and its two constituent components, negative affectivity (NA) and social inhibition (SI), are associated with health behaviors, quality of life (QoL), and mental distress among colorectal cancer (CRC) survivors. Methods: A population-based study was conducted among 2,620 CRC patients diagnosed between 2000 and 2009, who completed measures of personality (DS14), health behaviors, QoL (EORTC QLQ-C30), and mental distress (hospital anxiety and depression scale). Results: Personality was not associated with body mass index or smoking. Those scoring high on NA (with or without SI) were more often nondrinkers and less physically active compared to those scoring high on neither or only SI. Personality (high scores NA) and health behaviors (inactivity) were independently associated with poor QoL and mental distress. Conclusions: CRC survivors with high scores on NA are at risk of being inactive and have worse health outcomes.

Personality and psychological distress among older adult, long-term cancer survivors

ABSTRACTThis research examines a model of how personality (Five-Factor Model) is related to adjustment to cancer in later life in terms of the presence of continuing cancer-related worry and depression among older adult, long-term cancer survivors. Data from an NCI-funded study with 275 older adult (age 60+), long-term (5+ years) survivors of breast, prostate, and colorectal cancer were examined. Regression analyses identified neuroticism as the strongest predictor of cancer-related worry along with continuing cancer-related symptoms. For depression, three personality dimensions (neuroticism, conscientiousness, and agreeableness) were significant predictors. Findings suggest the importance of considering the central role that survivors' personality characteristics play in understanding cancer-related worries and depression. Understanding these dispositional characteristics is key for social workers and health-care practitioners in counseling survivors experiencing these common mental health effects.

Psychotic-Like Experiences and Psychological Distress: The Role of Resilience.

The occurrence of psychotic-like experiences and schizotypal features in the general nonclinical population may imply a connection with psychosis-related liability. This study was designed to examine the role of resilience in the relationship of hallucination and delusion-like experiences and schizotypal features to psychological distress in a nonclinical sample. The study sample (n = 432 university students) was selected through a stratified cluster sampling procedure, and measures of hallucination proneness, delusion proneness, schizotypal personality, and psychological distress were administered. While all three indices of psychotic-like experiences correlated with one another, only hallucination proneness and schizotypal personality features correlated with psychological distress and only schizotypal traits correlated with resilience. Schizotypy was found to have an indirect effect on distress through resilience. Findings imply the possibility of two types of schizotypy, with high or low resilience. It appears that schizotypes with low resilience may be susceptible to adversity and mental disorders, while high resilience may be protective.

The relationship between trait mindfulness, personality and psychological distress: A revised reinforcement sensitivity theory perspective

Interest in the application of mindfulness-based intervention for the treatment of psychological disorders and promotion of wellbeing has grown exponentially in recent years. Mindfulness-based interventions have been found to be beneficial for treatment of various forms of psychopathology as well as improve psychological wellbeing and enhance physical health. Little research has investigated for whom and under what conditions training people to use mindfulness-based therapeutic techniques is most effective. Recent studies have found evidence that individual differences in personality traits are associated with mindfulness. For example, neuroticism has been found to be negatively associated with mindfulness. These associations raise the possibility that individual differences in personality may potentially moderate the effectiveness of mindfulness-based interventions. In the present study we draw on Gray's revised Reinforcement Sensitivity Theory (r-RST) to examine relationships between personality traits, mindfulness and psychological distress. We found that the Flight, Fight, Freeze system mediated the relationship between trait mindfulness and psychological distress, while trait mindfulness moderated the relationship between the Flight, Fight, Freeze system and psychological distress. Both results are consistent with the suggestion that acquiring the skills from learning and practicing mindfulness techniques is potentially useful, particularly for threat-sensitive individuals with low to moderate levels of trait mindfulness.

A hidden type of internet addiction? Intense and addictive use of social networking sites in adolescents

Internet Gaming Disorder has been included as a preliminary diagnosis in DSM-5. The question remains, if there are additional internet activities related to addictive use. Especially, use of social networking sites has been discussed to be related to excessive use, but only few empirical studies are available. We wanted to explore, if use of social networking sites is related to addiction symptoms and psychosocial distress and which variables (demography, personality) predict addictive use. A representative sample of n = 9173 adolescents (12–19 years) was enrolled. Self-report questionnaires assessed demography, frequency of social networking sites use, internet addiction, personality, and psychosocial distress. Gender-specific associations were found between frequency of use of social networking sites and addiction criteria, especially regarding preoccupation and loss of control. Adolescents using social networking sites intensely were more often classified with internet addiction (4.1% boys, 3.6% girls) and displayed higher psychosocial distress. Frequency of social networking sites use and its addictive use were predicted by similar variables except for extraversion that was only related to frequency of use. Since the intense use of social networking sites can be related to addictive symptoms and is accompanied by psychosocial distress it might be considered as another form of addictive online behavior.

Personality and young adult financial distress

Researchers have become increasingly interested in understanding the sources of heterogeneity in individual financial behaviors. In this paper, we examine how the Big Five personality traits are related to measures of young adults’ financial distress. Using data from the National Longitudinal Study of Adolescent to Adult Health in the United States, we find that conscientiousness is negatively correlated, and neuroticism positively correlated with financial distress. These correlations are robust to controlling for early life background and other demographic and socioeconomic factors. Young adulthood sets the stage for financial security in later life; as such, this study provides insight for lifelong financial wellbeing. Based on the empirical results, we discuss potential behavioral and policy interventions that can be used to improve financial wellbeing.

Cloninger's psychobiological model of personality and psychological distress in fibromyalgia.

Personality can play an important role in the clinical symptoms of fibromyalgia (FM). The aim of this study is to identify personality profiles in FM patients and the possible presence of personality disorder (PD) from the Temperament and Character Inventory-Revised (TCI-R), and to assess whether personality dimensions are related to psychological distress in FM. The sample consisted of 42 patients with FM and 38 healthy controls. The TCI-R, Hospital Anxiety and Depression Scale, State-Trait Anxiety Inventory, Short-Form-36 Health Survey, Fibromyalgia Impact Questionnaire and McGill Pain Questionnaire were administered. The personality profile of the FM group based on the TCI-R is defined by high Harm Avoidance (HA), low Novelty Seeking (NS), and low Self-Directedness (SD). Only one-third of patients with FM present a possible psychometric PD, principally from Cluster C. In the FM group, HA and SD are associated positively and negatively, respectively, with indicators of emotional distress. Patients with higher HA present higher perceived pain intensity rated via a verbal-numerical scale while Determination (SD2) reduced the perceived level of pain induced by the stimulus. NS is negatively related to the number of work absences caused by FM. The study suggests that HA and SD play an important role in psychological distress in FM. The fact that SD is prone to modification and has a regulatory effect on emotional impulses is a key aspect to consider from the psychotherapeutic point of view.

Personality vulnerabilities in adolescent suicidality: The mediating role of psychological distress.

The research literature consistently indicates that self-criticism is related to suicidality. Evidence for the role of dependency, however, is more controversial. This study examines the extent to which these personality vulnerabilities are mediated by psychological distress in the prediction of suicidality. As part of a study of adolescent psychopathology, a sample of 260 Portuguese adolescents (148 [56.9 %] female and 112 [43.1%] male), ranging in age from 15 to 18 years (M = 16.32, SD = 1.19) completed measures of personality, suicidal behavior, and current distress, in counterbalanced order. The measures were: self-criticism and dependency from the Depressive Experiences Questionnaire for Adolescents; two psychological distress scales, social withdrawal from the Youth Self Report and depression from the Center for Epidemiologic Studies of Depression Scale; and a measure of suicidality from the Suicide Behaviors Questionnaire Revised. Structural equation modeling indicated that self-criticism and dependency were both significantly associated with suicidality. Psychological distress, however, as measured by withdrawal and depression, fully mediated these relationships, but did not moderate them. The authors conclude that adolescents with higher levels of self-criticism and dependency are at greater risk for experiencing intense psychological distress-high levels of social withdrawal and depression-that account for their vulnerability to suicide risk.

Indirect and Direct Associations Between Personality and Psychological Distress Mediated by Dispositional Coping

ABSTRACTThe present study examines the association between coping and personality, by testing the hypothesis that dispositional coping mediates the relationship between personality and psychological distress. Canonical correlations evaluated the degree of the association among personality and coping dimensions in a community sample (N = 489) from Cyprus. Results partially support the hypothesized mediation model with Agreeableness predicting distress through the full mediation of avoidant coping, expression of negative feelings and active-positive coping. Partial mediation was found for Neuroticism and Openness. Canonical correlations deciphered how coping relates to the Big Five dimensions. Neuroticism was mostly associated with maladaptive coping, whereas Conscientiousness and Extraversion with adaptive coping.

A study of personality subtypes in treatment seeking obese patients

Previous research has not been able to identify a distinct personality style that refers specifically to obese individuals. The purpose of this investigation was to explore whether different personality-based groups can be identified in obese individuals, as has been shown with eating disorder patients. Data were collected from 149 obese patients (BMI = 37.3, ± 6.4; 83% female) seeking dietary treatment and psychological support for their weight problems. Participants completed the Millon Clinical Multiaxial Inventory III (MCMI-III; Millon, 1997) and a battery of eight measures assessing psychological distress, mood states, eating behaviors, obesity-related quality of life, and interpersonal problems. The MCMI-III personality scales were cluster analysed to classify participants into personality subtypes. Three personality clusters were retained (externalizing, internalizing, high-functioning), and several differences in the validating variables emerged across the three personality subtypes. The internalizing group reported the greatest level of personality distress and an increased likelihood of poor psychosocial functioning and high eating behavior symptoms. Findings support the clinical utility of personality subtypes in obesity. Future work is needed to identify causal pathways between personality typologies and eating disorders in obese individuals.

Personality and self-esteem in emerging adults with Type 1 diabetes

ObjectiveThe present study examined (1) mean-level differences in self-esteem and Big Five personality traits between individuals with and without diabetes; and (2) demographic, clinical, and psychological correlates of patients' self-esteem and Big Five. Research design and methodsA total of 478 emerging adults with Type 1 diabetes (18–35years old) were selected from the Belgian Diabetes Registry and completed questionnaires on personality, self-esteem, and diabetes-related distress. The control group consisted of 341 healthy participants who were matched (1:1) on sex and age with the patient group. ResultsFirst, mean-level differences between patients and controls differed according to patients' sex and illness duration. Women with diabetes reported lower self-esteem and were less extraverted and emotionally stable as compared to female controls. In contrast, men with diabetes reported higher self-esteem and were more agreeable but less emotionally stable as compared to male controls. Furthermore, whereas both patients with shorter and longer illness duration were less extraverted and emotionally stable as compared to controls, only patients with longer illness duration reported heightened agreeableness. Second, self-esteem and Big Five were found to relate to patients' sex and (to a lesser extent) age and illness duration. Finally, patients reporting elevated diabetes-related distress reported lower self-esteem, and were less agreeable and emotionally stable as compared to patients not reporting such distress. ConclusionsPatients' personality and self-esteem might be important targets for future prevention and intervention efforts. The present findings can assist healthcare professionals in identifying those patients who might benefit the most from such programs.

The distressed (Type D) and Five-Factor Models of personality in young, healthy adults and their association with emotional inhibition and distress

The distressed (Type D) personality (the combination of negative affectivity and social inhibition traits) has been associated with adverse health outcomes. This study investigated the validity of the Type D construct against the Five-Factor Model (FFM) of personality, and its association with emotional control and distress. In total 498 university students (mean age 28.9±8.4years) completed the Type D scale (DS14), and measurements for the FFM of personality, emotional control, anxiety, depression and stress. The construct validity of the Icelandic DS14 was confirmed. The Type D components negative affectivity and social inhibition were strongly associated with neuroticism and extraversion of the FFM (r=0.82 and r=−0.67, respectively). Negative affectivity also correlated with rehearsal/rumination (r=0.58) and social inhibition with emotional inhibition (r=0.54), indicative of emotional control. Type D personality (40% of sample) was associated with higher levels of anxiety, depression and stress. The Type D personality components were associated with the FFM of personality, emotional control and emotional distress. Importantly, social and emotional inhibition were closely related, providing novel information about the presence of emotional inhibition within the social inhibition trait.

Personality and Fibromyalgia Syndrome

Objectives: We aimed to review how personality characteristics contribute to the onset, maintenance or modulation of fibromyalgia. Method: The databases Medline and PsychINFO were examined from 1967 to 2012 to identify studies that investigated associations between fibromyalgia and personality. Search terms included fibromyalgia and personality, trait psychology, characteristics and individual differences.Results: Numerous studies indicate that patients with fibromyalgia experience psychological distress. Various instruments have been used to evaluate distress and related psychological domains, such as anxiety or depression, in fibromyalgia. In many cases, these same instruments have been used to study personality characteristics in fibromyalgia with a subsequent blurring of cause and effect between personality and psychological distress. In addition, the symptoms of fibromyalgia may change pre-illness personality characteristics themselves. These issues make it difficult to identify specific personality characteristics that might influence the fibromyalgia process. Despite this inherent problem with the methodologies used in the studies that make up this literature review, or perhaps because of it, we found no defined personality profile specific to fibromyalgia. However, many patients with fibromyalgia do show personality characteristics that facilitate psychological responses to stressful situations, such as catastrophising or poor coping techniques, and these in turn associate with mechanisms contributing to fibromyalgia.Conclusion: No specific fibromyalgia personality is defined but it is proposed that personality is an important filter that modulates a person’s response to psychological stressors. Certain personalities may facilitate translation of these stressors to physiological responses driving the fibromyalgia mechanism.

Aggressiveness, sexuality, and obsessiveness in late stages of ALS patients and their effects on caregivers

Clinical experience has shown an increase of behavioural and mood symptoms, especially in the areas of aggressiveness, sexuality and obsessiveness, during the late stages of ALS. The lack of conclusive data concerning these symptoms prompted us to assess the psychological aspects of ALS patients in advanced stages of the disease. Moreover, we evaluated the personality of their caregivers in order to analyse the relationship between the pair. For these purposes, we studied 10 patients with ALS in late stages (tracheostomized for 36 months) and their caregivers using a questionnaire specifically elaborated for patients' communication limits. To assess the state of anxiety and depression of both patients and caregivers, we used the Hospital Anxiety and Depression Scale (HADS). To investigate caregivers' personality, we administered the Big Five Questionnaire (BFQ). Data showed a trend of aggression and high level of obsessiveness in ALS patients, associated with several clinical characteristics. High levels of anxiety emerged in both patients and caregivers. Regarding BFQ, caregivers obtained higher scores in the dimension of Conscientiousness and very low scores in Extraversion and Emotional Stability. In conclusion, the study showed a potential and considerable effect of the long duration of ALS on patients' personality and caregivers' distress.

Genome‐wide association uncovers shared genetic effects among personality traits and mood states

Measures of personality and psychological distress are correlated and exhibit genetic covariance. We conducted univariate genome-wide SNP (~2.5 million) and gene-based association analyses of these traits and examined the overlap in results across traits, including a prediction analysis of mood states using genetic polygenic scores for personality. Measures of neuroticism, extraversion, and symptoms of anxiety, depression, and general psychological distress were collected in eight European cohorts (n ranged 546-1,338; maximum total n = 6,268) whose mean age ranged from 55 to 79 years. Meta-analysis of the cohort results was performed, with follow-up associations of the top SNPs and genes investigated in independent cohorts (n = 527-6,032). Suggestive association (P = 8 × 10(-8)) of rs1079196 in the FHIT gene was observed with symptoms of anxiety. Other notable associations (P < 6.09 × 10(-6)) included SNPs in five genes for neuroticism (LCE3C, POLR3A, LMAN1L, ULK3, SCAMP2), KIAA0802 for extraversion, and NOS1 for general psychological distress. An association between symptoms of depression and rs7582472 (near to MGAT5 and NCKAP5) was replicated in two independent samples, but other replication findings were less consistent. Gene-based tests identified a significant locus on chromosome 15 (spanning five genes) associated with neuroticism which replicated (P < 0.05) in an independent cohort. Support for common genetic effects among personality and mood (particularly neuroticism and depressive symptoms) was found in terms of SNP association overlap and polygenic score prediction. The variance explained by individual SNPs was very small (up to 1%) confirming that there are no moderate/large effects of common SNPs on personality and related traits.

The interactive role of distress tolerance and borderline personality disorder in suicide attempts among substance users in residential treatment

The primary purpose of this study was to examine the interactive effect of borderline personality disorder (BPD) and distress tolerance (DT) on suicidal behavior across levels of intent to die (clear vs ambiguous) and medical severity. One hundred seventy-six adult patients in residential substance use disorder treatment were administered a series of structured interviews, behavioral assessments, and self-report questionnaires. A series of analyses of covariance and multiple regression analyses were conducted to test hypotheses using both categorical and dimensional measures of BPD and DT. Analyses supported hypotheses, indicating that patients with BPD who exhibit high DT are at the greatest risk for engaging in chronic and medically serious suicidal behavior. Although high DT is unlikely to be inherently problematic, results suggest that within the context of severe psychopathology (eg, co-occurring BPD–substance use disorder), the ability to withstand aversive internal states in pursuit of a goal (eg, one's own death) may enable individuals to persist in otherwise unsustainable behavior. In this sense, DT may function in a manner consistent with the acquired capability for suicide (a component of the interpersonal-psychological theory of suicidal behavior defined by a diminished fear of death and enhanced tolerance for pain that, in the presence of suicidal desire, enables individuals to enact lethal self-injury).

Playing it safe: An examination of risk-avoidance in an anxious treatment-seeking sample

It has been argued that individuals who are anxious are less likely and willing to take perceived risks across multiple behavioral domains (e.g., social, recreational, financial etc.), and that this bias is likely implicated in the etiology of pathological anxiety. While evidence is accumulating, there has been minimal research investigating the characteristics of risk-avoidance across anxiety disorders and across the specific risk-taking domains. The current study investigated risk-avoidance across domains in an anxious treatment-seeking sample. We hypothesized that: (i) individuals with anxiety would be more risk averse across domains relative to healthy controls; and, (ii) risk-avoidance would predict unique variance in anxiety symptoms, above and beyond other vulnerability factors (e.g., neuroticism). Individuals diagnosed with one or more anxiety disorders (n=67) completed measures of risk-taking, anxiety and depression symptoms, personality, and psychological distress. Healthy controls (n=58) completed measures of risk-taking and psychological distress. Results partially confirmed our hypotheses, demonstrating that anxious individuals were significantly more risk averse relative to controls across most domains, even after controlling for age and psychological distress. Furthermore, specific domains were found to account for unique variance in specific anxiety symptoms, as well as symptoms of depression. The results of this study provide novel evidence to suggest that risk-aversion is a possible transdiagnostic factor contributing to anxiety pathology.

Chinese students in Japan: The mediator and the moderator between their personality and mental health

To clarify the influence of personality traits on the psychological acculturation of Chinese international students in Japan, the present study used three structuring questions: (a) What personality trait makes the students vulnerable to psychological distress? (b) What mediates between personality and psychological distress? (c) What buffers personality from psychological distress? The study examined personality traits (Harm-Avoidance, HA; and Self-Directedness, SD; two dimensions of the Temperament and Character Inventory), acculturation attitudes (integration, assimilation, separation, and marginalization), and the mental health (General Health Questionnaire (GHQ)-30) of 253 Chinese students in Japan (17-30 years of age) using self-report questionnaires. The hypotheses are: For the Chinese international students in Japan, (a) the individuals with high HA or low SD are more vulnerable to psychological distress; (b) the acculturation strategy mediates between personality (HA/SD) and mental health (GHQ); (c) social support can moderate the effect of personality on acculturation adaptation. The results show that the Chinese international students in Japan had higher GHQ scores compared to normative standards, and marginalization (a less adaptive strategy) was their second most preferred acculturation strategy, next to integration. Individuals with high HA or low SD were more likely to have a marginalization attitude and suffer from more psychological distress. The mediation effect of marginalization and the moderation effect of social support in life (SSL) between HA/SD and GHQ were confirmed. Most of the hypotheses were supported by the results. Explanations of these findings and their implication for acculturation adaptation are discussed.