Personality assessment in chronic pain patients / Avaliação da personalidade em pacientes com dor crônica

Abstract In Brazil, studies investigating the personality characteristics of chronic pain patients are scarce. The present study aimed to evaluate the personality characteristics of patients with chronic pain and to compare them with those of patients without this condition. To this end, the Personality Disorders Dimensional Inventory and the Hypochondriasis scale of the Brazilian version of the Minnesota Multiphasic Personality Inventory were administered. Two different statistical analyses were carried out: the t - test to determine the differences between the scores for the two groups and the logistic regression analysis to examine the predictive power of the scales for the diagnosis of chronic pain. The results revealed significant differences (p < 0.05) among the Histrionic, Hypochondriasis, and Sadistic scales as predictors for the groups studied, with larger effect sizes on the Histrionic and Hypochondriasis scales. The authors suggest that the use of these scales in a clinical context may provide important information for health professionals.

Resumo No Brasil, estudos investigando as características da personalidade em pacientes com dor crônica são escassos. O objetivo da presente pesquisa foi avaliar as características da personalidade em pacientes com dor crônica e compará-las com as de pessoas sem esse diagnóstico. Para tanto, foram aplicados o Inventário Dimensional de Transtornos da Personalidade e a Escala de Hipocondria da versão brasileira do Minnesota Multiphasic Personality Inventory. Duas análises estatísticas distintas foram empregadas, sendo elas o teste t, para verificar diferenças entre as pontuações dos dois grupos, e a análise de regressão logística, para investigar a capacidade preditiva das escalas para o diagnóstico de dor crônica. Os resultados indicaram diferenças significativas (p < 0,05) nas escalas Histriônico, Hipocondria e Sádico como preditores dos grupos estabelecidos, com maiores magnitudes as escalas Histriônico e Hipocondria. Os autores sugerem que o uso das escalas para o contexto clínico pode agregar informações relevantes para o profissional.

Assessment and emergency management of suicidality in personality disorders.

This article examines the association between suicidal behavior and personality disorders. It updates the review of epidemiological evidence for the association between suicidal behavior and suicide in individuals who have a personality disorder diagnosis, particularly in borderline personality disorder (BPD). The second part of the article presents new empirical evidence that characterizes suicidal behavior in patients who have BPD, specifically examining patient characteristics that differentiate patients who have BPD with a history of high versus low lethality suicide attempts. Finally, the article discusses the approach to a patient who has BPD and presents to the emergency department because of an increased risk of suicide.

MMPI assessment of the DSM-III-R histrionic personality disorder.

This study investigated the MMPI characteristics of a group of 25 Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) histrionic personality disorder patients, contrasted with a mixed group of 57 other personality disorder patients. All patients were diagnosed by means of a semistructured interview (SCID-II; Spitzer, Williams, & Gibbon, 1987). Effects for diagnostic category were found for MMPI Scales 9 (Ma), 0 (Si) and for the HST scale, developed by Morey, Waugh, and Blashfield (1985) for the diagnosis of the histrionic personality disorder. Further analysis of the results revealed that these MMPI scales, and especially the HST scale, mainly assess a social introversion-extraversion dimension, on which histrionic inpatients can be differentiated from nonhistrionic inpatients. This study does not offer direct empirical support for the use of the HST scale as a measurement of the DSM-III-R histrionic personality disorder concept.

The MCMI provides a good assessment of DSM-III disorders: the MCMI-II will prove even better.

Although the arguments that Widiger, Williams, Spitzer and Frances muster in their appraisal of MCMI-DSM-III relationships appear compelling, the study employed to furnish empirical support for their thesis may be seriously flawed and the item content approach they propose as a validation model is judged logically and psychometrically deficient. A rejoinder with supportive data are presented to demonstrate both the substantive parallels and the clinical concordance that exist between MCMI and DSM-III criteria. On the basis of theory development and ongoing research, a new MCMI-II assessment instrument will be forthcoming. A brief summary of this updated inventory's rationale and empirical grounding is provided.

[Results of long-term catamnesis of neurotic and psychopathic states and assessment of the prognosis]. / Rezul'taty dlitel'nogo katamneza nevroticheskikh i psikhopaticheskikh sostoianii i otsenka prognoza.

The results of long-term follow-up studies indicate the existence of significant differences in the outcome of neurotic and psychopathic states. The most unfavorable outcome was seen in patients with asthenic and unstable psychopathy. A classification of a "good" and "poor" outcome of the disease by means of a computer permitted to distinguish the most significant anamnestic and clinical signs indicating a possible unfavorable prognosis. In the most unfavorable variant of the disease (21% of 124 psychopathic patients) in asthenic, unstable, excitative and hysterical psychopathy there were states with prevalently neurotic and psychopathic symptomatology, nonspecific for any of the above-mentioned forms of psychopathy.

[Epidemiological factors and personality structure]. / Epidemiologische Faktoren und Persönlichkeitsstruktur.

The relation between sociodemographic characteristics and structure of personality (MMPI) was analyzed using the results of the "Basle Adolescence Study". Type of housing, family structure, employment of the mother and number of working hours of the father produced statistically significant differences, which, however, were small in respect to the general variability of the structure of personality.

Short vs long hospitalization. A controlled study: III. Inpatient results for nonschizophrenics.

A controlled, prospective, two-year follow-up study examined the relative effectiveness of short-term vs long-term psychiatric hospitalization. Results of the inpatient phase for a sample of 74 nonschizophrenic patients are reported here. About four weeks after admission the patients hospitalized for a short stay were discharged, and at that time were functioning better than the patients in the long-stay group. When the patients hospitalized for a long stay were discharged, three to fur months after admission, they were then functioning as well as, but not noticeably better than, the patients in the short-stay group had been at their earlier time of discharge. Patients with affective disorders were more impaired at admission and improved more than patients with other diagnoses, regardless of length of stay.