The association between personality types and medication adherence among adult hypertensive patients

OBJECTIVE: To investigate the prevalence of adherence to antihypertensive medication and its association with personality types among adult hypertensive patients. DESIGN AND METHODS: This was a cross-sectional study, which used the Big Five Inventory to assess personality types and Morisky Medication Adherence Scale (MMAS-8) to measure antihypertensive medication adherence, among a convenience sample of 301 hypertensive primary-care patients. Chi square tests, t-tests, correlations and regression techniques were used to examine associations between variables. RESULTS: The mean MMAS-8 score was 5.00 ñ 1.69. Most respondent (60%) demonstrated low adherence (score <6) with only 7% achieving high adherence (score = 8). Persons who scored highly for neuroticism were less likely to be adherent [OR = 0.30; (0.10-0.88)], as were the employed compared to the unemployed [(OR = 0.34; (0.14-0.86)]. In contrast, older persons demonstrated higher adherence levels [(OR = 1.06 (1.01-1.11)]. Regression model variables accounted for 13% of variance in antihypertensive adherence. CONCLUSIONS: This sample demonstrated low antihypertensive adherence; lowest for those high on the neuroticism scale, the employed and younger participants. This implies personality type should be considered in managing chronic diseases to identify clients requiring intervention, thereby improving control, reducing morbidity and enhancing efficient use of scarce resources. Efforts are also needed to address other risk factors that impact adherence.

School violence reduction: a model Jamaican secondary school program

Violence in United States' schools is epidemic. Solutions are rare. Community mental health centers are now being challenged to become part of the solution. The Montego Bay Secondary School project presents an example of how violence reduction can be achieved using almost no physical resources and the special effect, called the "Bruno Effect", created by one Jamaican police offficer with the consultation of a psychodynamically-led training and intervention team. The "Bruno Effect" resulted in a dramatic reduction in the number of physical attacks from an observed 5 fights per day (3 out of the 5 involved knives and cuttings) to 1 per week. The violence rate returned immediately to its former level as soon as "Bruno" left the school. The dramatic violence reduction appears related to establishing an adult protective shield. Results stem from the unique personality of the adult protector, as well as a combination of the special role of the police and the outside intervention team.(AU)

The psychophysiological mediators of stress as it relates to oncology in humans and animals

This study was designed to investigate the effect of stress on cancer development and treatment, and also to determine whether there is any cancer association personality profile. Human studies were supplemented by controlled animal studies. Twenty-nine male and female cancer subjects were studied along with twenty-nine controls. The animal study comprised ninety female Sprague-Dawley rats, which were divided into nine groups of ten. One group was treated with noise stress alone, while another group received no treatment at all. Three groups received the carcinogen 7,12-Dimethylbenz(a)anthracene together with either noise stress, cortisone acetate or 6-mercaptopurine and the rate of tumour growth in these animals was compared to a group that received only the carcinogen, and after tumour growth these animals were subjected to chemotherapy. In addition to the chemotherapy, one of these groups received noise stress and another cortisone acetate. The stress level of the humans and animals was determined by physiological and psychological tests where applicable. The results of the human study revealed that the level of stress among the cancer subjects was higher than among the controls. Even though in some cases cancer development occured after an event that may be considered stressful, it was not easy to conclude whether stress occurred before or after the cancer development. The controlled animal studies revealed, though, that stress alone could not induce tumour development in the observation period of 280 days. Stress, however, influenced tumour growth when the rats were treated with the carcinogen. The findings of this study also suggested that immunosuppression might play a vital role in cancer development. A cancer associated personality profile, depicting among other things a schizophrenic character, was also detected among the human cancer subjects. The treatment of the cancer subjects who had high stress levels was less successful, and this was substantiated by the results of the animal study, which showed that stressed decreased the life span of the animals receiving chemotherapy and stress. The findings of this study suggest that even though stress may not initiate tumour growth, stress influences the growth of potential tumour cells, and may interfere with the response to treatment (AU)

Towards a typology of behaviour patterns among West Indian adolescents

The internal-external control dimension (I.E.) derived from social learning theory described two characteristic "world views" or generalized expectancies concerning reinforcement. One group of individuals view the locus of casuality for personality relevant events as external. Others view events products of their own actions. Thus individuals are conceived as varying along a "Locus Control" dimension, with the end points labelled internal and external. In a study of 375 adolescents, the author investigated the prediction of the locus of control and simultaneously self-esteem. This paper describes four behaviour patterns that occur with some regularity in West Indian adolescents. These categories are relative, not absolute. Nevertheless, most pupils observed in the course of this research displayed certain traits and qualities to such a degree that their behaviour could be viewed as more representative of one of the conceptual categories than others (AU)

Psychosocial functioning of mothers of malnourished children

The relationship between infant malnutrition and maternal psychosocial behavior was explored by comparing mothers of malnourished children with mothers whose children were matched for age and family income but were not malnourished. The mothers were interviewed and asked to describe their relationships with their children, their children's fathers, extended families, friends, and employers. The mothers of malnourished children described more chronically disrupted lives. Their housing conditions and employment records reflected disorganization. They had fewer social contacts except with extended families who supervised excessively. The fathers of their babies were either not present or unsupportive. Relationships were more stereotyped, transient, and focused on material aspects. The mothers' narcissistic concerns took precedence over the needs of their children. Nearly all the mothers, including the controls, had suffered severe deprivation in childhood. Some mothers of malnourished children were apathetic and dependent, whereas others were manipulative and evasive. These findings were consistent with "failure-to-thrive" in affluent countries.(AU)