Premorbid Personality Characteristics Research Articles

Analysis of Educational Attainment in a Mexican Psychiatric Patient Population with Bipolar or Psychotic Disorders.

Schizophrenia has been associated with premorbid poor educational performance and low educational attainment (EA). However, some studies have found positive associations between psychotic disorders and excellent scholastic performance. In the present study, we examined the association between EA and several clinical and nonclinical characteristics in psychiatric patients diagnosed with psychotic or bipolar disorders. Data were obtained from the files of 1132 patients who entered a major Mexico City psychiatric hospital during the years 2009-2010 for the treatment of psychotic symptoms and who were subsequently diagnosed with schizophrenia, bipolar, schizoaffective, or another psychotic disorder. Chi-squared tests, t-tests, and Cox regression analysis were applied to explore associations between EA and factors including gender, familial history of mental illness, premorbid personality characteristics, age of symptom onset, diagnosis, civil status, and current employment. Family history of mental illness decreased the hazard of having lower EA (B = -0.137, p = 0.025, ExpB = 0.872, 95% CI = 0.774-0.983), while a schizophrenia diagnosis independently increased it (B = 0.201, p = 0.004, ExpB = 1.223, 95% CI = 1.068-1.401). In male patients (but not in females), family history of mental illness was significantly associated with higher EA, while in female patients, premorbid schizoid-like personality characteristics were associated with lower EA. For both genders, lower EA was associated with having more children and being employed in manual labor, while higher EA was associated with professional employment. Conclusions: Compared with bipolar disorder, a schizophrenia diagnosis is associated with lower EA; however, familial history of mental illness and premorbid schizoid-like characteristics independently favor higher and lower EA in males and females, respectively. Since lower EA is generally associated with a lower economic status, special preventative attention should be given to students at high risk for schizophrenia, particularly those displaying a schizoid-like personality.

Personality traits as risk factors for the development of cognitive impairment and affective symptoms in patients with COVID-19

To identify possible associations between premorbid personality traits and cognitive impairment and affective symptoms in patients who have recovered from COVID-19. The study included 30 people with the so-called post-COVID syndrome. The diagnosis of COVID-19 was previously confirmed by laboratory tests in each patient. The control group included 15 healthy individuals. The Hospital Anxiety and Depression Scale was used to assess depression and anxiety. Cognitive function was assessed using the Verbal Fluency Test (VF), the Montreal Cognitive Scale (MOCA), and the Wisconsin Card Sorting Test (WCST). The Munich Personality Test (MRT) and the Toronto Alexithymia Scale (TAS-26) were used to assess premorbid personality characteristics. Multiple stepwise regression analysis was used as the main statistical method to identify the relationship between premorbid personality constructs and cognitive test results and affective and anxiety symptoms. The presence of frustration tolerance in the personality structure reduced the number of incorrect answers (beta coefficient -0.811) in WCST and decreased the delay in responses with positive reinforcement (-0.630), and also reduced the level of depression (-0.465). Extraversion decreased the MOCA test score (-0.675) and increased the percentage of perseverative incorrect answers on the WCST test (0.573). The constructs of adherence to social norms and propensity to isolate lowered the final MOCA score (beta coefficients are -0.725 and -0.527, respectively). The esoteric tendencies construct decreased the latency of positive and negative reinforcement responses in WCST (-0.441 and -0.528, respectively). The severity of alexithymia was positively correlated with depression (beta 0.577), while neuroticism was positively correlated with anxiety (0.737). Low levels of frustration tolerance and esoteric tendencies have negative effects on cognition in COVID-19 survivors, while high levels of these constructs are protective against cognitive decline and depression.

Post-traumatic Stress Disorder after Severe Traumatic Brain Injury: A Systematic Review.

The review aimed to summarize the existing knowledge base regarding post-traumatic stress disorder after severe traumatic brain injury (TBI) and try to guide future research. Web of Science, Scopus, and PubMed databases were used to identify original studies that explored the relationship between severe TBI and post-traumatic stress disorder. A total of 13 studies were included in the review. They have been examined in terms of potentially compatible and incompatible mechanisms, as well as of possible confounding factors in relation to the diagnosis of post-traumatic stress disorder after severe TBI. Only a few studies in the literature have addressed the present topic; therefore, the prevalence of post-traumatic stress disorder in patients with severe TBI still needs to be further investigated. In particular, future studies should be conducted only in severe TBI populations, considering their premorbid personality characteristics and their reactivity alteration. They should also obtain an accurate and appropriate assessment of post-traumatic stress disorder with clinical interviews as well as clarifying the role of post-traumatic amnesia in this population by incorporating control groups of patients.

Comparative study of the anxiety, depression and complaience of patients with somatoform disorders before and after treatment

Somatoform disorders are a widely spread group in the category of neurotic diseases, which expressed polymorphism, difficulty of diagnosis. They are important for financial health policy, patients with somatoform disorders make up 25 % of all patients with somatic disorders, «absorbing» up to 20 % of all funds spent on health. Somatoform disorders are characterized by recurrent somatic symptoms, the requirement of regular medical examinations. Somatoform disorders are characterized by the apparent lack of instrumental confirmed organic disorders, a predominance of complex psycho-vegetative disorders and the relative reversibility of symptoms. The purpose of this study is to compare the quality of patients’ life with somatoform disorders before and after treatment in a psychiatric department. At admission the patients were given to fill in a specialized questionnaire 1, developed during that investigation by psychiatrist Navasardyan E.V., with which help was estimated the duration and quality of treatment somatoform disorders by doctors of other specialties before admission to a psychiatric department. It was estimated frequency assignment psychotropic drugs by doctors of other specialties, premorbid personality characteristics of such patients, the incidence of acute and chronic stress before the onset of the disease, the patients’ attitude to their disease. Also, at admission the patients were given to fill in the questionnaire MMPI edited Berezin. At admission and discharge from psychiatric department the patients were assessed the level of anxiety (using the Spielberger questionnaire) and depression (using Beck questionnaire). Also, at discharge from the psychiatric department the patients were given to fill in the questionnaire Level of subjective control. Also the patients were given to fill in specialized questionnaire 2 developed during these study with which help were assessed the patients’ condition at discharge from the psychiatric department, future plans of the patients for treatment and the patients’ attitude to their disease. In a result of initial questioning at admission were identified that after detect the first signs of disease the majority of patients went to the doctors another specialties who treated their somatoform disorder from 1 up to 3 months, half of the patients were prescribed psychotropic therapy, which the most of patients no effect was. Most often a neurologist prescribed psychotropic drugs, and from the neurologist most patients received a recommendation to contact a psychiatrist. Also most of the patients were in a chronic stress before disease onset. Most patients associate their disease with nervous shocks, consider themselves to be anxious and paranoid. At admission most patients had strong fixation on their condition, as well as high indicators on scales of depression, anxiety and hypochondria (by questionnaire MMPI). At admission most patients are revealed a moderate degree of anxiety and depression respectively. Most patients are revealed the low level of General internality that corresponds to a low subjective control. In a result of treatment with secondary questioning by questionnaire 2 most patients indicated lower levels of anxiety and depression, as well as reducing hypochondriacal fixation on their condition, a significant decrease in the severity of somatoform disorders. Most patients were satisfied with the treatment, patients agreed that their disease psychologically caused, patients also agreed to continue to take psychotropic drugs after discharge.

On the learning of addictive behavior: Sensation-seeking propensity predicts dopamine turnover in dorsal striatum

We asked if sensation-seeking is linked to premorbid personality characteristics in patients with addictive disorders, or the characteristics follow the sensation-seeking activity. We interpreted the former as a state associated with normal rates of dopamine synthesis, and the latter as a trait of individuals with abnormally high rates of synthesis. We previously determined dopaminergic receptor density in striatum, and we now tested the hypothesis that an elevated dopaminergic condition with increased extracellular dopamine and receptor density follows increased dopamine synthesis capacity in highly sensation-seeking individuals, as measured by positron emission tomography of 18 men with tracer fluorodopa (FDOPA). We detected a site in left caudate nucleus where the volume of distribution of FDOPA-derived metabolites correlated negatively with FDOPA metabolite turnover, consistent with decreased metabolite breakdown in highly sensation-seeking subjects. High rates of sensation-seeking attenuated the dopamine turnover in association with a low rate of dopamine recycling, low dopamine oxidation, and elevated extracellular dopamine and receptors in caudate nucleus. In contrast, low rates of sensation-seeking were associated with rapid dopamine recycling, rapid dopamine oxidation, low extracellular dopamine, and low receptor density. We conclude that the modulation of dopaminergic neurotransmission associated with sensation-seeking is a state of sensation-seeking, rather than a trait of personality following abnormal regulation of dopaminergic neurotransmission.

THE ROLE OF PSYCHOLOGICAL REHABILITATION IN THE TREATMENT OF PATIENTS WITH LUNG TUBERCULOSIS

The article is devoted to current issues of psychological rehabilitation of patients with pulmonary tuberculosis. The article focuses on the specifics of psychological assistance. Itsubstantiates the need to organize special psychocorrectional programs aimed at overcoming premorbid elements of the relationship system, which are considered as psychological risk factors for the occurrence of the tuberculous process and its relapses.Keywords:pulmonary tuberculosis, psychological rehabilitation, premorbid personality characteristics, relationship system, therapeutic targets

Identification and characteristics of post-traumatic stress disorder in patients with multiple sclerosis

The fourth edition of the Diagnostic and Statistical Manual on Mental Disorders (DSM-IV) recognizes the existence of a disease as a potential life-threatening stressor capable of causing post-traumatic stress disorder (PTSD). This research is one of the first works dedicated to the study of PTSD in patients diagnosed with «multiple sclerosis» (RS). A total of 724 complete sample patients were screened for outpatient treatment at the «City MS Center» in Saint Petersburg. According to the results of the screening survey and the expert clinical interview for the verification of the diagnosis of PTSD, the clinic—psychopathological signs sufficient for the diagnosis of PTSD have been identified in 61 patients, which is 8.4% of the total number of screened patients. The presence of PTSD is confirmed by high indices of sub-scales «avoidance», «intrusion», «physiological excitability» on the WOVTS scale, as well as higher indicators of dissociation level compared to control group. The lack of correlation between PTSD and the duration of RS, the degree of disability of patients, as well as socio-demographic data was found. Thus, the development of PTSD is more related to the premorbid personality characteristics than to the characteristics of the disease. These findings suggest that RS may have PTSD-type reactions. Further studies of the psychological characteristics of this group of patients are needed to identify the targets for psychotherapy.

Psychopathological characterisitic of infertile women with sexual dysfunctions in assister reproductive technologies programs

To study the psychopathological characteristics of infertile women with sexual disorders in assisted reproductive technologies (ART) programs to develop therapeutic and rehabilitative interventions and improve the quality of life of the couple. An open continuous comparative descriptive study of sexual health, psychopathological features and personality characteristics of 589 women with infertility seeking treatment using ART was performed in 2013-2017. Clinical-psychopathological, sexological and psychometric methods were used. Non-psychotic mental disorders, predominantly anxiety disorders (28.0%), were identified in 58,9% of patients. Sexual dysfunctions of a disease level, among which prevailed disorder of libido (25.0%), were identified in 18.34% of patients. A high comorbidity of sexual dysfunctions and borderline mental disorders was detected (100% in patients with sexual dysfunctions versus 44.9% in patients without sexual disorders). an analysis of premorbid personality characteristics and severity of psychopathological symptoms based on the results of mpt, scl - 90 showed that patients with sexual disorders scored significantly lower on domains 'extroversion' and 'tolerance to frustration', while scores on 'esoteric tendencies', 'neuroticism', 'obsession', 'sensitivity', 'depression', 'anxiety', 'hostility' and 'psychoticism' were higher; significant positive and negative correlations between domains were noted. Increased or high levels of anhedonia assessed with scale SHAPS were found in 100% of patients, 43.8% had alexithymia according to TAS and 18.19% showed increased and high levels of asthenia (MFI-20). Characteristics of the psychopathological structure of sexual dysfunctions in women with infertility in ART programs should be taken into account in the development of treatment and rehabilitation options and improvement of quality of life of the couple.

COMBINED USE OF ANIMAL-ASSISTED THERAPY AND PSYCHOTHERAPY IN THE REHABILITATION OF COMBATANTS

The work is devoted to solving the problems of definition, etiology and pathogenesis of primary diagnostics of posttraumatic stress disorder in combatants of the antiterrorist operation, who had rehabilitation in sanatorium and resort conditions. As a result of the study, the positive impact of hyppotherapy on the psychological state of combatants in the antiterrorist operation was shown, which was applied on the basis of the Psychosocial Rehabilitation Center Feldman Ecopark in sanatorium and resort conditions with medical and psychological rehabilitation. The main groups (clusters) of neurotic, pathopersonological and psychopathological manifestations in this contingent of patients are identified. The study also showed that the testees experienced childhood sexual abuse (or forcing entry into sexual relations with someone from the immediate environment of the child) correlated with higher levels of both depressive and anxiety symptoms later in adulthood. Premorbid personality characteristics of patients with posttraumatic stress disorder are heterogeneous. Although people in natural conditions that provoke anxiety are especially likely to develop post-traumatic stress disorder, these disorders often arise in obsessive, dependent and even schizoid personality type. However, it would be logical to expect that those individuals accessed via the questionnaire with higher level of neuroticism (or «big anxiety») are more likely to develop symptoms of posttraumatic stress disorder than those of phlegmatic temperament.

Mental disorders in patients breast cancer: Differentiated approach to the study Nozogeny

ObjectiveThe problem of mental disorders in patients with breast cancer is relevant due to the high prevalence of pathological changes in the mental health patients, insufficient development of clinical typology of psychosomatic correlations of the contribution of constitutional features.MethodsNozogeny disorders are clinically heterogeneous and are represented by two nosologic categories: reaction and nosogenic patho-characterological personal development. The basic method of work was a clinical follow-up and statistical research methods (method using contingency tables and Fechner coefficient method using the χ2 – test).ResultsThe manifestation of a nozogeny reaction is closely correlated with his premorbid personality characteristics. Anxious-depressive nozogeny reaction was recorded in 17 patients of the first sample with high direct correlation (coefficient Fechner F = 0.76, P < 0.01) with respect to accentuation of personality in the alarm type, and the weak direct link to the personal characteristics of the affective (bipolar) range (F = 0.22, P < 0.01). Anxious-nozogeny dissociative response was detected in 9 patients with hysterical (55.5%) and expansive schizotypal (vershrobene) (44.4%) lung cancer with a significant (F = 0.65, P < 0.01) a direct correlation with constitutional hyperthymia, anxiety-hypomanic nozogeny response was observed in patients c schizotypal RL (n = 4) paired with symptoms of persistent hyperthymia (F = 0.39, P = 0.012).ConclusionPatho-characterological development of personality are formed on the remote catamnestic stage breast cancer and show the clinical heterogeneity of differentiation into 4 types: (1) the type of hypochondriacal dysthymia, (2) the type of “paranoia struggle”, (3) in an “aberrant hypochondria” and (4) the type of “new life”.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Mental disorders in patients with breast cancer: a differentiated approach to the study of nozogeny

To study mental disorders in patients with breast cancer (BC) at different stages of the disease taking into account premorbid characteristics and psychosomatic correlations in their development. The study included 82 patients with histologically confirmed BC. The first group consisted of 30 patients (mean age 49.7±11.1 years) with the first established diagnosis of BC and mental disorders caused by somatic disease (ICD-10 F40-F48, stress-related neurotic and somatoform disorders). The second group included 52 patients (mean age 56.8±6.7 years) with illness duration and follow-up ≥3 years (17 years in some cases) with signs of personality disorder (PD) according to ICD-10 F62. Clinical/pschopathological, follow-up and statistical methods were used. Mental disorders are represented by two nosologic categories: nosogenic reactions and pathological personality. Manifestation of a nozogeny reaction is closely correlated with premorbid personality characteristics. Anxious - depressive nozogenic reaction (n=17) is strongly correlated with the anxious type of personality accentuation and weakly correlated with personality characteristics of the affective (bipolar) range. Anxious-nozogenic dissociative response (n=9) was characteristic of hysterical and expansive schizotypal PD with a significant direct correlation with constitutional hyperthymia. Anxiety - hypomanic nozogeny response (n=4) was observed in schizotypal PD correlated with symptoms of persistent hyperthymia. Five types of PD are formed in the follow-up period: hypochondriacal dysthymia, 'paranoia struggle', 'aberrant hypochondria', hypomanic endoform response with the phenomenon of post-traumatic growth and 'new life'.

The specific features of the psycho-emotional status and the application of psychotherapy for the rehabilitative treatment of the patients presenting with rheumatoid arthritis

The relevance of the problem of rheumatoid arthritis arises from the influence of such factors as its prevalence rate, unpredictability, tendency towards the transition to the chronic form, severe pain syndrome, high levels of disability, and long-term loss of working ability, as well as the accompanying psycho-emotional disorders. The present reviews article was designed to analyze the premorbid personality characteristics, the specifics features of mental health, and the response to the disease in the patients presenting with rheumatoid arthritis. Special emphasis is placed on the discusses of the relationship between the intensity of the pain syndrome and psycho-emotional disorders. The factors responsible for the development of the depressive states associated with rheumatoid arthritis are distinguished; they are shown to be related to both pathogenesis and the clinical symptoms of the underlying pathology as well as the general course of the disease and the specific features of the patients' psychological condition. The most extensively applied psychodiagnostics techniques are described, and the commonest psychotherapeutic approaches to the combined therapy and rehabilitation of the patients presenting with rheumatoid arthritis are overviewed.

Premorbid personality characteristics and CSF markers of Alzheimer's pathology

Background Beginning as early as in young adulthood, personality characteristics may contribute to cognitive reserve by their influence on lifestyle and health-related behavior. A resilient personality profile may be associated with less cognitive and functional impairment in persons with cerebral Alzheimer's disease (AD) pathology. Aim The aim of this study was to investigate whether premorbid personality characteristics modulate the relationships between cognitive performance and AD pathology as measured using CSF biomarkers at preclinical and early clinical disease stages. Subjects and methods Sixty-eight patients with mild cognitive impairment or mild dementia and forty-two older subjects with normal cognition have been included. Premorbid personality characteristics were assessed by the NEO Personality Inventory Revised (as reported by a close relative) along with cognitive performance, functional status and CSF concentrations of Aβ1-42, tau, and ptau181. Multivariate regression analysis, including age, gender, education years, and APOEe4 genotype was used to evaluate associations between disease severity and premorbid personality scores, and the CSF markers of AD pathology. Results Overall, there were significant associations between Clinical dementia rating-Sum of boxes (CDRSOB) and the interactions of each personality trait with the ptau181/Aβ1-42 ratio. In subjects with cognitive impairment, there were significant associations between CDRSOB and the interactions of ptau181/Aβ1-42 ratio with Neuroticism, Extraversion, Openness and Conscientiousness. Significant results were also found using the interaction between different personality traits and the tau/Aβ1-42 to predict the CDRSOB. Discussion The findings suggest that premorbid personality characteristics modify the relationship between cerebral pathology and cognitive performance at very early clinical stages of AD.

Maternal attachment insecurity is a potent predictor of depressive symptoms in the early postnatal period

Maternal attachment insecurity is a potent predictor of depressive symptoms in the early postnatal period

Exploring the Relationship Between Premorbid Personality and Dementia-Related Behaviors

The purpose of the current study was to investigate whether premorbid personality traits (i.e., neuroticism, extroversion, openness, agreeableness, and conscientiousness) can predict behavioral and psychological symptoms of dementia (BPSD). In particular, agitation-related behaviors were examined. The current study used convenience sampling from 14 residential care facilities in Melbourne, Australia. Demographic and health data, cognitive ability, BPSD, and premorbid personality characteristics were collected from 62 female and 27 male older adults. Close informants of participants were asked to provide premorbid personality data (i.e., before the development of dementia) using the NEO-Five-Factor Inventory. Residential care staff used the Cohen-Mansfield Agitation Inventory to rate agitation-related behaviors over a 2-week period. Correlational analyses revealed associations between premorbid agreeableness and verbally nonaggressive behaviors, and between premorbid conscientiousness and verbally nonaggressive behaviors. Although the findings provide some support that premorbid personality shapes problematic behaviors exhibited in dementia, they are inconsistent with previous research and the hypotheses were generally not supported.

Anti-social personality characteristics and psychotic symptoms: Two pathways associated with offending in schizophrenia.

Several research groups have shown that people with schizophrenia who offend do not form a homogenous group. A three-group model claimed by Hodgins proposes distinguishing between people who start offending before the onset of psychosis (early starters), after psychosis onset but at age 34 years or under (late starters) and after psychosis onset but at age 35 years or older (late first offenders). This study aimed to test the hypotheses (1) that the personality of early starters and non-psychotic offenders would be similar, but different from either late-starter group; (2) that the late-starter groups would be more likely to have positive psychotic symptoms than non-criminal patients with schizophrenia; and (3) that symptom types would differentiate the psychotic groups. A retrospective file study was conducted on cases of 97 early starters, 100 late starters and 26 late first offenders all drawn from the Netherlands Institute of Forensic Psychiatry and Psychology (NIFP) archives 1993-2008, 115 non-psychotic offenders from 2005-2008 NIFP archives and 129 patients with schizophrenia and no criminal history from one general service in Rotterdam. Early starters closely resembled the non-psychotic offenders in their premorbid anti-social personality characteristics. The two late-onset offending psychosis groups were more likely to have persecutory and/or grandiose delusions than non-offenders with psychosis, but so were the early starters. In a first study to compare subgroups of offenders with psychosis directly with non-psychotic offenders and non-offenders with psychosis, we found such additional support for a distinction between early and late starters with psychosis that different treatment strategies would seem indicated, focusing on personality and substance misuse for the former but psychotic symptoms for all. It remains to be seen whether the higher rate of alcohol misuse amongst late first offenders is a fundamental distinction or a function of age difference.

Premorbid Personality and the Risk of Parkinson’s Disease

Background: Previous studies support the hypothesis that premorbid personality characteristics may be associated with the risk of Parkinson’s disease (PD). However, most of these relied upon subjective reports of premorbid personality earlier in life, which may be subject to recall bias. The objective of the current study was to evaluate the association of PD with risk-taking, routinization, smoking and alcohol consumption in early-adult life as indicators of premorbid personality. Methods: In-person interviews were conducted with 89 PD patients and 99 controls from a university-based medical center. Associations between indicators of early-adult personality and risk of PD were examined using logistic regression. Results: Adjusting for age, sex and education, taking or wanting to take more activity risks as a young adult was inversely associated with the risk of PD in the entire sample (odds ratio (OR) = 0.78 (95% confidence interval (CI) 0.63 - 0.97)). Among women, higher levels of routinization as a young adult were associated with an increased risk of PD (OR = 1.63 (95% CI 1.05 - 2.53)). Conclusions: Parkinson patients were more likely to take or want to take fewer risks in early-adult life and to prefer a more routine lifestyle than controls, suggesting that individuals with PD may have distinctive premorbid personality characteristics.

Premorbid Personality and the Risk of Parkinson’s Disease

Background : Previous studies support the hypothesis that premorbid personality characteristics may be associated with the risk of Parkinson’s disease (PD). However, most of these relied upon subjective reports of premorbid personality earlier in life, which may be subject to recall bias. The objective of the current study was t o evaluate the association of PD with risk-taking, routinization, smoking and alcohol consumption in early-adult life as indicators of premorbid personality. Methods: In-person interviews were conducted with 89 PD patients and 99 controls from a university-based medical center. Associations between indicators of early-adult personality and risk of PD were examined using logistic regression. Results: Adjusting for age, sex and education, taking or wanting to take more activity risks as a young adult was inversely associated with the risk of PD in the entire sample (odds ratio (OR) = 0.78 (95% confidence interval (CI) 0.63 - 0.97)). Among women, higher levels of routinization as a young adult were associated with an increased risk of PD (OR = 1.63 (95% CI 1.05 - 2.53)). Conclusions: Parkinson patients were more likely to take or want to take fewer risks in early-adult life and to prefer a more routine lifestyle than controls, suggesting that individuals with PD may have distinctive premorbid personality characteristics. J Neurol Res. 2014;4(2-3):81-87 doi: http://dx.doi.org/ 10.14740 / jnr281w

EPA-1384 – The missing link between dissociative amnesia and dementia

Introduction Despite suggestions that chronic stress is involved in the pathogeny of dementias, no systematic studies investigated the possibility of a link between dissociative amnesia and neurodegenerative dementias. Methods We analyzed data from over a dozen patients with functional dissociative amnesia, whom we investigated with neuropsychological methods, structural and functional neuroimaging. We followed prospectively approximately half of these patients for more than a decade. Results We evidenced in a substantial sample of patients with dissociative amnesia with preponderant retrograde memory impairments a hypometabolism during resting state in the right temporo-frontal region, with a decrease in the infero-lateral prefrontal cortex. Additional preliminary data from DTI suggested a decreased integrity of long distance fiber tracts important for conscious mnemonic processing. We found a chronic course of the memory impairments in a substantial number of patients with dissociative amnesic conditions. In some chronic cases of dissociative amnesia we noted a fairly stable course, while in other cases we observed a progressive global cognitive deterioration. Discussion These findings point to a non-homogenous course of dissociative amnesia. Conclusion The search for a link between dissociative amnesic conditions and dementia should take into consideration multiple variables, such as the age at the onset of trauma, gender, the recurrence, type and severity of trauma, the presence of psychiatric and medical co-morbidity, pre-morbid personality characteristics (e.g. neuroticism), genetic polymorphisms, educational and occupational attainment, cognitive reserve and the progression of metabolic and microstructural brain changes.

Premorbid personality characteristics and attachment style moderate the effect of injury severity on occupational outcome in traumatic brain injury: Another aspect of reserve

The concept of “reserve” has been proposed to account for the mismatch between brain pathology and its clinical expression. Prior efforts to characterize this concept focused mostly on brain or cognitive reserve measures. The present study was a preliminary attempt to evaluate premorbid personality and emotional aspects as potential moderators in moderate-to-severe traumatic brain injury. Using structural equation modeling and multiple regression analyses, we found that premorbid personality characteristics provided the most robust moderator of injury severity on occupational outcome. Findings offer preliminary support for premorbid personality features as another relevant reserve construct in predicting outcome in this population.