Abstract Background Conventional rTMS protocols for major depression commonly employ stimulation sessions lasting >30 min. However, recent studies have sought to improve costs, capacities, and ...outcomes by employing briefer protocols such as theta burst stimulation (iTBS). Objective To compare safety, effectiveness, and outcome predictors for DMPFC-rTMS with 10 Hz (30 min) versus iTBS (6 min) protocols, in a large, naturalistic, retrospective case series. Methods A chart review identified 185 patients with a medication-resistant major depressive episode who underwent 20-30 sessions of DMPFC-rTMS (10 Hz, n = 98; iTBS, n = 87) at a single Canadian clinic from 2011 to 2014. Results Clinical characteristics of 10 Hz and iTBS patients did not differ prior to treatment, aside from significantly higher age in iTBS patients. A total 7912 runs of DMPFC-rTMS (10 Hz, 4274; iTBS, 3638) were administered, without any seizures or other serious adverse events, and no significant differences in rates of premature discontinuation between groups. Dichotomous outcomes did not differ significantly between groups (Response/remission rates: Beck Depression Inventory-II: 10 Hz, 40.6%/29.2%; iTBS, 43.0%/31.0%. 17-item Hamilton Rating Scale for Depression: 10 Hz, 50.6%/38.5%; iTBS, 48.5%/27.9%). On continuous outcomes, there was no significant difference between groups in pre-treatment or post-treatment scores, or percent improvement on either measure. Mixed-effects modeling revealed no significant group-by-time interaction on either measure. Conclusions Both 10 Hz and iTBS DMPFC-rTMS appear safe and tolerable at 120% resting motor threshold. The effectiveness of 6 min iTBS and 30 min 10 Hz protocols appears comparable. Randomized trials comparing 10 Hz to iTBS may be warranted.
There is debate over the definition of narcissism across social/personality and clinical psychology. The current article aims to quantify the level of disagreement by measuring experts' opinions ...concerning the attributes most central to narcissism. Accordingly, we developed a comprehensive list of attributes associated with narcissism and had 49 self-identified experts (among them 17 women, 23 psychologists from clinical psychology and 22 from social/personality psychology) rate these characteristics and provide their opinions on several issues related to the conceptualization of narcissism. Experts generally believe that the grandiose features of narcissism are more central than the vulnerable features. However, differences between clinical and social/personality psychologists were evident, especially regarding the relevance of self-esteem. Given the results, we suggest that researchers specify the kind of narcissism being assessed in a given study and consider using assessments of the full range of narcissistic features in future research to provide a more comprehensive perspective on the construct.
Abstract Background The present study investigated individual differences in the Affective Neuroscience Personality Scales (ANPS) , representing measures of primary emotional systems, and depressive ...tendencies in two independent samples. Methods In order to be able to find support for a continuum model with respect to the relation of strength in the cross-species “affective neuroscience” taxonomy of primary emotional systems, we investigated ANPS measured personality traits in a psychologically mostly healthy population (n = 614 participants) as well as a sample of clinically depressed people (n = 55 depressed patients). Results In both normal and depressed samples robust associations appeared between higher FEAR and SADNESS scores and depressive tendencies. A similar – albeit weaker – association was observed with lower SEEKING system scores and higher depressive tendencies, an effect again seen in both samples. Limitations The study is of cross-sectional nature and therefore only associations between primary emotional systems and depressive tendencies were evaluated. Conclusions These results show that similar associations between ANPS monitored primary emotional systems and tendencies toward depression can be observed in both healthy and depressed participants. This lends support for a continuum of affective changes accompanying depression, potentially reflecting differences in specific brain emotional system activities in both affectively normal as well as clinically depressed individuals.
The personality dimension of schizotypy is well established, and schizotypal traits can be taken to represent a proneness toward developing psychosis. Yet, there are competing theories about the ...latent structure of schizotypy. More specifically, there is controversy over the extent to which this propensity toward psychosis is present only in a small proportion of the population, or whether it is spread dimensionally throughout the general community. On the basis of accumulating research findings the present article argues for a fully dimensional model of schizotypy. It describes recent neurobiological, neuropsychological, social and environmental evidence supporting the idea that schizotypy in healthy populations, and disorders on the schizophrenia spectrum are fundamentally linked. Directions for further research are also considered.
There is an ongoing debate regarding the nature of narcissism such that some argue that narcissistic individuals oscillate between grandiose and vulnerable states, whereas others argue these ...dimensions are stable traits (e.g., grandiose individuals remain in grandiose states). Scales sensitive to fluctuations in narcissistic states are necessary to address this question. The current study (N = 1,613 across three samples) validates the newly developed Narcissistic Vulnerability Scale (NVS), a brief (11-item) adjective-based measure of vulnerable narcissism. Expert ratings were used for item selection. The NVS's factor structure was evaluated along with its correlations with measures of grandiose and vulnerable narcissism, five-factor model traits, and self-esteem. A subset of NVS items were also evaluated using an ecological momentary assessment design. Results indicate the NVS is a unidimensional measure of vulnerable narcissism that could be used in either trait-oriented or state-oriented analyses, the latter of which may be particularly well suited to answering the most pressing questions in the study of narcissism.
Public Significance Statement
A short adjective-based measure of vulnerable narcissism was developed. Its results are consistent with those of popular measures of trait vulnerable narcissism, but it is suitable for measuring more temporary vulnerable narcissism states. It is the first validated measure of vulnerable narcissism well suited for measuring short-term fluctuations in vulnerable narcissism.
Abstract Background We examine whether broad factors and specific facets of personality are associated with increased risk of incident Alzheimer's disease (AD) in a long-run longitudinal study and a ...meta-analysis of published studies. Methods Participants (n = 1671) were monitored for up to 22 years from a baseline personality assessment. The meta-analysis pooled results from up to five prospective studies (n = 5054). Results Individuals with scores in the top quartile of neuroticism (hazard ratio = 3.1; 95% confidence interval = 1.6–6.0) or the lowest quartile of conscientiousness (hazard ratio = 3.3; 95% confidence interval = 1.4–7.4) had a threefold increased risk of incident AD. Among the components of these traits, self-discipline and depression had the strongest associations with incident AD. The meta-analysis confirmed the associations of neuroticism ( P = 2 × 10−9 ) and conscientiousness ( P = 2 × 10−6 ), along with weaker effects for openness and agreeableness ( P < .05). Conclusions The current study and meta-analysis indicate that personality traits are associated with increased risk of AD, with effect sizes similar to those of well-established clinical and lifestyle risk factors.
The PTSD Checklist (PCL) is the most frequently used self-report measure of PTSD symptoms. Although the PCL has been in use for nearly 20
years and over a dozen validation studies have been ...conducted, this paper provides the first comprehensive review of its diagnostic utility. Eighteen diagnostic accuracy studies of the PCL are presented, followed by an examination of the potential roles of spectrum effects, bias, and prevalence in understanding the variation in sensitivity, specificity, and other operating characteristics across these studies. Two related issues as to the interchangeability of the PCL's three versions (civilian, military, and specific) and various scoring methods are also discussed. Findings indicate that the PCL has several strengths as a PTSD screening test and suggest that it can be a useful tool when followed by a second-tier diagnostic test such as a standardized interview. However, the PCL's operating characteristics demonstrate significant variation across populations, settings, and research methods and few studies have examined such factors that may moderate the PCL's utility. Recommendations and cautions regarding the use of the PCL as a clinical screening test, a diagnostic tool in research, and as an estimator of PTSD population prevalence are provided.
►The PTSD Checklist has several strengths as a PTSD screening test ►The PTSD Checklist's diagnostic accuracy is affected by spectrum and bias ►The interchangeability of the PTSD Checklist's three versions requires verification ►More research is needed regarding the utility of scoring rules commonly employed
•Selection effects are evident between neuroticism and interpersonal chronic stress, total non-interpersonal episodic stress, and dependent non-interpersonal episodic stress.•Socialization effects ...are evident between total chronic stress, interpersonal chronic stress, non-interpersonal chronic stress, and dependent non-interpersonal episodic stress and neuroticism.•Life stress and neuroticism do not operate independently and can serve as key intervention targets for adolescents.
Background: Stressful life experiences and personality can influence one another. Personality may contribute to the amount and type of stress individuals experience, which is referred to as a selection effect. Life stress may also impact one's personality, which is referred to as a socialization effect. It was hypothesized that neuroticism would predict increased chronic and episodic stress (selection effect) and that chronic and episodic stress would predict increased neuroticism (socialization effect).
Methods: The current study investigated selection and socialization effects of neuroticism and life stress over a three-year period in 627 adolescents. Life stress data were examined in terms of duration (chronic versus episodic) and type (interpersonal versus non-interpersonal). Episodic stress data were examined as dependent or independent.
Results: The results from ten cross-lagged panel models provided some evidence for significant selection and socialization effects depending on stress type. Over three years, we observed that neuroticism increases interpersonal chronic stress and non-interpersonal stressful events (selection effects) and that dependent non-interpersonal stressful events and chronic stress increase neuroticism (socialization effects).
Limitations: Study limitations include a lack of a lifespan perspective and a statistical approach that does not differentiate between- from within-person variance.
Conclusions: Findings suggest the value of attending to stress response as well as targeting neuroticism in prevention and intervention approaches in adolescents.
IMPORTANCE: Personality phenotype has been associated with subsequent dementia in studies of older adults. However, neuropathologic changes often precede cognitive symptoms by many years and may ...affect personality itself. Therefore, it is unclear whether supposed dementia-prone personality profiles (high neuroticism and low conscientiousness) are true risk factors or merely reflections of preexisting disease. OBJECTIVES: To examine whether personality during adolescence—a time when preclinical dementia pathology is unlikely to be present—confers risk of dementia in later life and to test whether associations could be accounted for by health factors in adolescence or differed across socioeconomic status (SES). DESIGN, SETTING, AND PARTICIPANTS: Cohort study in the United States. Participants were members of Project Talent, a national sample of high school students in 1960. Individuals were identified who received a dementia-associated International Classification of Diseases, Ninth Revision (ICD-9) diagnosis code during any year between 2011 and 2013. The dates of our analysis were March 2018 to May 2019. EXPOSURES: Ten personality traits were measured by the 150-item Project Talent Personality Inventory. Socioeconomic status was measured by a composite based on parental educational level, income, occupation, and property ownership. Participants were also surveyed on demographic factors and height and weight. MAIN OUTCOMES AND MEASURES: Medicare records were collected, with dementia diagnoses in the period of 2011 to 2013 classified according to the US Centers for Medicare & Medicaid Services ICD-9–based algorithm. Cox proportional hazards regression models estimated the relative risk of dementia based on the 10 personality traits, testing interactions with SES and adjusting for demographic confounders. RESULTS: The sample of 82 232 participants was 50.1% female, with a mean (SD) age of 15.8 (1.7) years at baseline and 69.5 (1.2) years at follow-up. Lower risk of dementia was associated with higher levels of vigor (hazard ratio for 1 SD, 0.93; 95% CI, 0.90-0.97; P < .001). Calm and maturity showed protective associations with later dementia that increased with SES. At 1 SD of SES, calm showed a hazard ratio of 0.89 (95% CI, 0.84-0.95; P < .001 for the interaction) and maturity showed a hazard ratio of 0.90 (95% CI, 0.85-0.96; P = .001 for the interaction). CONCLUSIONS AND RELEVANCE: This study’s findings suggest that the adolescent personality traits associated with later-life dementia are similar to those observed in studies of older persons. Moreover, the reduction in dementia risk associated with a calm and mature adolescent phenotype may be greater at higher levels of SES. Personality phenotype may be a true independent risk factor for dementia by age 70 years, preceding it by almost 5 decades and interacting with adolescent socioeconomic conditions.
The most widely used measure of trait narcissism is the Narcissistic Personality Inventory (NPI), which can provide both total and subscale scores. However, with a length of 40 items, this measure ...may not be ideal in settings in which time or participant attention may limit the types of measures that can be administered. In response, Ames, Rose, and Anderson (2006) created the NPI-16, which provides a shorter, unidimensional measure of the construct. In the present research, we examine the reliability and validity of the NPI-16 in conjunction with a new short measure of narcissism, the NPI-13, which provides both a total score and 3 subscale scores (Leadership/Authority; Grandiose Exhibitionism; Entitlement/Exploitativeness). Across 2 studies, we demonstrate that both short measures manifest good convergent and discriminant validity and adequate overall reliability. The NPI-13 may be favored over the NPI-16 because it allows for the extraction of 3 subscales, consistent with the use of its parent measure.
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