Distinguishing between neurosis and psychosis: discourses on neurosis in colonial Korea.

This article analyses the origins and formation of medical and social discourses on neurosis in colonial Korea. With the introduction of Western medicine after the Opening of Korea in 1876, neurasthenia and hysteria began to be understood as neurotic diseases, and their importance was further highlighted during the colonial period of 1910-45. The article also addresses the role of neuropsychiatry in forming discourses on neurosis. In medical communities during the colonial period, the main source of these discourses gradually shifted from internal medicine to neuropsychiatry. In particular, Korean neuropsychiatrists distinguished between neurosis and psychosis as a way to reinforce their authority. Neuropsychiatrists tried to explain the temperamental and environmental factors of neurosis from a psychoanalytic standpoint.

Shared and specific genetic risk factors for lifetime major depression, depressive symptoms and neuroticism in three population-based twin samples.

BACKGROUND: Vulnerability to depression can be measured in different ways. We here examine how genetic risk factors are inter-related for lifetime major depression (MD), self-report current depressive symptoms and the personality trait Neuroticism. METHOD: We obtained data from three population-based adult twin samples (Virginia n = 4672, Australia #1 n = 3598 and Australia #2 n = 1878) to which we fitted a common factor model where risk for 'broadly defined depression' was indexed by (i) lifetime MD assessed at personal interview, (ii) depressive symptoms, and (iii) neuroticism. We examined the proportion of genetic risk for MD deriving from the common factor v. specific to MD in each sample and then analyzed them jointly. Structural equation modeling was conducted in Mx. RESULTS: The best fit models in all samples included additive genetic and unique environmental effects. The proportion of genetic effects unique to lifetime MD and not shared with the broad depression common factor in the three samples were estimated as 77, 61, and 65%, respectively. A cross-sample mega-analysis model fit well and estimated that 65% of the genetic risk for MD was unique. CONCLUSION: A large proportion of genetic risk factors for lifetime MD was not, in the samples studied, captured by a common factor for broadly defined depression utilizing MD and self-report measures of current depressive symptoms and Neuroticism. The genetic substrate for MD may reflect neurobiological processes underlying the episodic nature of its cognitive, motor and neurovegetative manifestations, which are not well indexed by current depressive symptom and neuroticism.

[Does the French Big Five Inventory evaluate facets other than the Big Five factors?] / Le Big Five Inventory français permet-il d'évaluer des facettes en plus des cinq grands facteurs ?

INTRODUCTION: The Big Five Inventory (BFI) developed by John et al. (1991) is one of the most widely accepted tools for assessing dimensions of personality. It comprises 44 items that assess five broad dimensions of personality (the Big Five Factors): Extraversion, Agreeableness, Conscientiousness, Neuroticism and Openness to experience. Based on correlations with the facets described in the NEO Personality Inventory Revised (NEO PI-R), another Big Five assessment tool with 240 items and 6 facets per dimension, Soto and John (2009) showed that the dimensions in the BFI could be divided into two facets each (ten facets altogether). These results are in line with those of DeYoung et al. (2007), who ran factorial analyses with all the NEO PI-R facets and the International Personality Item Pool (IPIP) and identified ten intermediate factors (between facets and dimensions) which they called "aspects" (two per dimension). The goal of the present study is to investigate the ten facets described by Soto and John in a French sample, using the French version of the BFI (BFI-Fr), which has good psychometric properties, and to check whether the pattern of correlations of these facets with the NEO PI-R match those of the American version. METHOD: We created three groups. The first comprised 360 students from the Institut libre d'éducation physique supérieure (ILEPS) and Tours University (psychology undergraduates). Participants (mean age 21.1 years±2.30; 58% women) completed the BFI-Fr and the NEO PI-R. The second comprised 142 psychology students from Tours University (mean age 20.6 years±1.78; 81% women); they completed the BFI-Fr twice, two weeks apart (test and retest). The third comprised 252 psychology students from Paris-Nanterre University (mean age 23 years±4.2; 89% women) who described a total of 405 people they knew well (mean age 35.2±10.8; 49% women) using the peer-report format of the BFI-Fr. RESULTS: In the self-report format, eight of Soto and John's ten aspects had acceptable internal consistency (based on Guildford's (1954) internal consistency criteria, due to the small number of items), with Cronbach's α between 0.60 and 0.86 and test-retest correlations between 0.71 and 0.89, showing satisfactory temporal stability. We found a single facet for Extraversion (Assertiveness), two for Agreeableness (Altruism and Compliance), two for Conscientiousness (Self-Discipline and Order), one for Neuroticism (Anxiety), and two for Openness to Experience (Openness to aesthetics and Openness to ideas). Based on their convergence with the corresponding facets in the NEO PI-R, these eight facets showed satisfactory external validity. With regard to the peer-report format, the Activity facet of Extraversion, which did not have sufficient internal consistency in the self-report format, had acceptable properties (i.e. 9 out of 10 facets). Only the Depression facet of Neuroticism still had insufficient internal consistency. In this study, we proposed an improvement of two facets (Activity and Compliance) and added one facet specific to the French version (Emotional Instability) in place of the Depression facet. DISCUSSION: We showed that the BFI-Fr can be used to assess nine of the ten facets described by Soto and John. We also identified an Emotional Instability facet, replacing the Depression facet of Neuroticism. DeYoung et al. (2007) considered that anxiety and depression are indissociable and can be represented by a Neuroticism aspect they labeled Withdrawal. They suggested a second aspect of this dimension they called Volatility (with the N2 Angry Hostility facet of the NEO PI-R as main marker and the N5 Impulsiveness and N3 Depression as secondary markers). The Emotional Instability facet we found corresponds closely to the N2 Angry Hostility facet of the NEO PI-R and appears to be a satisfactory marker of DeYoung et al.'s (2007) Volatility aspect. Although this study has limitations, particularly related to the samples (students), the BFI-Fr facets (derived from those defined by Soto and John in the BFI or proposed as improvements on the original facets) match the corresponding NEO PI-R facets and can also be seen as main markers of the aspects defined by DeYoung et al.

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.

[Alienation: Differential Psychopathology of Ego-Disturbances]. / Entfremdungserlebnisse ­ Psychopathologische Differenzierung der Ich-Störungen.

Alienation, i. e. disorders of the inner experience of integrity, continuity, and agency, represents a feature of both psychotic and non-psychotic disorders. Thereby, ego disturbances are thought to be specific for schizophrenia. Depersonalisation, in contrast, has been reported in schizophrenia as well as a neurotic, probably distinct syndrome. The differentiation of psychotic vs. non-psychotic alienation is often all but trivial. The present paper provides an overview of the historical roots and the psychopathological conceptualizations of alienation. Clinically relevant features of psychotic alienation are highlighted. Experience of passivity, loss of authenticity and disturbances of striving and volition appear as psychotic characteristics.

[The diagnostic usability of selected narrativity indices in stories about close relationships in the assessment of personality organization]. / Uzytecznosc wybranych wskazników narracyjnosci wypowiedzi na temat relacji interpersonalnych w diagnozie poziomów organizacji osobowosci.

AIM: The aim of this study was to test the usability of selected narrativity indices identified from autobiographical accounts of important relationships in an assessment of neurotic (NPO) and borderline personality organization (BPO). METHODS: Narrativity indices, both particular and generalized, were used to predict personality organization levels. Indices were derived from two separate layers of analysis: 1) lexical indices were counted with computer assistance; 2) evocative/reception indices dealing with coherence of the story were assessed using the competent judges method. RESULTS: It was found that the lexical narrativity index-the active "I"-was a good predictor of both BPO and NPO, while the human factor was a good predictor of BPO when low. Moreover, a generalized index was used to describe how stories are saturated with the narrativity indices of intentionality, concreteness, and active "I", but simultaneously deprived of human factor, and was found to be the best predictor of BPO. Furthermore, where the coherence of the story and of its subdimension (integration) rise, the probability of BPO diagnosis decreases. CONCLUSIONS: This research provides support for the thesis that surface narrativity indices may predict deeper personality structure. Its results are justified in the light of Kernberg's theory, and have the potential to become a useful tool in clinical practice as a supplementary source of information in diagnostic and psychotherapeutic processes.

[HEALTH STATUS AND DEVELOPMENT OF CHILDREN BORN USING IVF].

In the work the analysis of incidence, the dynamics of physical development during the first year of life among 28 children born using IVF was conducted. It was found out that during the first year of life these children have certain patterns of growth and development, as well as a wide range of diagnosed pathology. Thereby observing children of this category should be optimized.

Comprehensive questionnaire for assessment of Dhat syndrome: development and use in patient population.

INTRODUCTION: Dhat syndrome is a culture-bound syndrome, characterized by the core belief of loss of semen accompanied by symptoms of general weakness, lack of energy and concentration, impaired sexual functions, and vague somatic troubles, often associated with an anxious or dysphoric mood state. Although many studies have described the clinical picture of Dhat syndrome, there is lack of availability of an instrument which can comprehensively assess patients presenting with Dhat syndrome. AIM: The aim of this article is to develop a questionnaire that can comprehensively assess Dhat syndrome and guide the clinicians in managing such patients. METHODS: Initially, an extensive literature review was done to prepare a comprehensive list of clinical features, beliefs associated with the passage of "Dhat," and attribution of the symptoms by the patients. These items were converted into a questionnaire for investigational interview. The questionnaire thus developed was administered to 54 patients and was also sent to eight subject experts for their opinion on the questionnaire. MAIN OUTCOME MEASURE: To develop and evaluate the content validity of the Comprehensive Questionnaire for Assessment of Dhat Syndrome. RESULTS: As per the opinion of experts, the questionnaire had good content validity and was useful for not only clinicians dealing with patients of Dhat syndrome but was also considered useful for the patients presenting with Dhat syndrome. All the experts found the questionnaire to be comprehensive, and two-third of the experts regarded the length to be adequate. Although none of them suggested any deletion of items, yet some additions were suggested. The language of the questionnaire was rated from simple to very simple. Results of administration of the questionnaire on 54 patients of Dhat syndrome established that the questionnaire was helpful in providing comprehensive clinical picture of Dhat syndrome. CONCLUSION: The questionnaire designed for the purposes of this study is a useful instrument for comprehensive assessment of the clinical picture of Dhat syndrome.

Self-stigma and suicidality in patients with neurotic spectrum disorder - a cross sectional study.

BACKGROUND: Self-stigmatization is a step-by-step process during which the person uncritically accepts the societal negative evaluation and applies it to himself. Relation between self-stigma and suicidality in neurotic disorders is not known. The aim of our study was to find connection between self-stigma and the level of suicidality in neurotic spectrum disorders. METHOD: It was a cross-sectional study of 198 inpatients with pharmacoresistant neurotic spectrum disorders hospitalized at the psychotherapeutic ward of the Department of Psychiatry, University Hospital Olomouc. Patients were diagnosed using the ICD-10 research diagnostic criteria. The assessments included Internalized Stigma Of Mental Illness (ISMI), Beck Depression Inventory-second edition (BDI-II), objective and subjective Clinical Global Impression (CGI), Morin sleep scale, Dissociative Experience Scale (DES) and Montgomery and Asberg Depression Rating Scale, item 10 Suicidal Thoughts (MADRS item 10 suicidality) for the assessment. RESULTS: The subjective rate of suicidality and also the objective rate of suicidality were strongly positively correlated with the total score of ISMI. There were also significant correlations with all subscores except for the correlation between the BDI 9 and the sub score Resistance against stigma, which barely missed the level of statistical significance. CONCLUSIONS: More attention should be paid to self-stigma in neurotic patients, especially in those with suicidal thoughts and tendencies.

Self-stigma in psychiatric patients--standardization of the ISMI scale.

OBJECTIVE: Self-stigma in psychiatric patients is an issue deserving both research and therapeutic attention. The objective of the present study was to evaluate the psychometric properties of a Czech version of the Internalized Stigma of Mental Illness (ISMI) scale assessing the levels of self-stigma in individuals with mental disorders. METHODS: It consists of 29 items classified into 5 subscales, namely alienation, stereotype endorsement, perceived discrimination, social withdrawal and stigma resistance. The study group comprised 369 patients with a mean age of 41.5±13.3 years, of whom 210 (56.6%) were females. RESULTS: The most frequent diagnosis was neurotic disorders (46.1%), followed by affective disorders (18.4%), substance use disorders (13.3%), psychotic disorders (10.8%), personality disorders (9.5%) and organic disorders (1.6%). Reliability of the scale was evaluated by internal consistency analysis (α=0.91), the split-half method (Spearman-Brown coefficient: 0.93) and test-retest at 3 weeks from the first measurement (N=17; r=0.90, p<0.05). CONCLUSION: Exploratory factor analysis of the scale was performed, its validity was verified and norms were established that were based on T-scores and sten scores for the entire scale and individual subscales. The Czech translation of the ISMI has adequate psychometric properties.

Personality characteristics of patients seeking cosmetic rhinoplasty.

BACKGROUND: Rhinoplasty is one of the most common cosmetic surgeries performed on the face. Cosmetic surgery is performed not only to change the appearance, level of satisfaction, and self-confidence of the patient, it may also reflect specific personality patterns. The goal of this study was to investigate the personality characteristics of individuals seeking cosmetic rhinoplasty. METHODS: Thirty patients referred for rhinoplasty and 30 healthy age- and gender-matched controls were enrolled in this case-control study. All participants filled out the Millon Clinical Multiaxial Inventory 3rd edition and the data were analyzed using ANOVA and Fisher's exact test. RESULTS: Twenty-four (80 %) females and 6 (20 %) males were evaluated. Dependent, histrionic, and narcissistic personality disorders were seen in 2, 3, and 8 patients in the case group, respectively. The number of individuals with narcissistic personality traits was significantly higher in the case group than in the control group (p < 0.001). CONCLUSION: Narcissism is the most common psychological trait that motivates patients to seek a rhinoplasty. Personality disorders are not very common among individuals seeking rhinoplasty in Iran. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Family environment, personality, and psychological symptoms in adults sexually abused as children.

The current study examined the relationships between family environment characteristics, personality traits, and current psychological symptoms in adults with a history of child sexual abuse. Family environment characteristics, personality traits, and psychological symptoms in 18 abused and 18 nonabused college students were examined using ANOVAs and MANOVAs. Pearson product moment correlations were also performed. Results indicated significantly more dysfunctional family environment characteristics (inflexibility, poor cohesion, family dissatisfaction, and poor family communication) in the abused versus the nonabused group. There were significantly higher levels in the personality traits of neuroticism and openness to experience in the abused group; however, there were no significant differences in psychological symptoms when comparing the two groups. The implications of the results and areas of future research are discussed.

Psychogenic skin excoriations: diagnostic criteria, semiological analysis and psychiatric profiles.

Psychogenic excoriations are also called neurotic excoriations, dermatillomania or skin picking syndrome. We proposed diagnostic criteria and then performed a study of the psychiatric profiles of outpatients with psychogenic excoriations and the circumstances around the creation of these excoriations. Although the results must be interpreted with caution because the study was performed with only 10 patients, interesting data is provided about the onset of psychogenic excoriations, the behaviour of picking, and comorbidity. Common or specific characteristics were identified according to type of case. The majority of patients associated first excoriations with personal problems. Four patients reported abuse in childhood or adolescence. This study confirms that skin picking is an impulsive reaction and does not belong to the obsessive-compulsive disorders: impulsivity is defined by ineffective or failing control resulting in uninhibited behaviour.

The prevalence and correlates of neurotic disorders among undergraduates at a mainland Chinese university.

OBJECTIVES: To study the prevalence and risk factors of neurotic disorders (NDs) among Chinese university students. METHODS: Stratified random sampling was used to select students who were interviewed using the World Health Organization Composite International Diagnostic Interview Version 3.0 to diagnose psychiatric disorder and collected socio-demographic, and family structure and environment data. The response rate was 90 % (N = 1,843). The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) criteria were used to diagnose NDs. We used logistical regression to evaluate the links between NDs and selected correlates. RESULTS: The prevalence of NDs was 25.6 % (lifetime), 15.7 % (12-month), and 6.8 % (30-day) among the university students with no significant gender differences in these rates. No family structure characteristics were related to 12-month prevalence of NDs (P > 0.05). In contrast, family environment factors including a history of family disputes (OR 1.562, CI 1.108-2.203), parental mental health problems (OR 1.800, CI 1.379-2.349), and absence of care in childhood (OR 1.916, 95 % CI 1.331-2.759) were associated with higher prevalence rates of NDs. CONCLUSIONS: Our findings show a high prevalence of NDs in this sample of Chinese undergraduates. Social environment factors, in the student's family of orientation, were significantly associated with the prevalence of NDs. These findings support the importance of negative family experiences during childhood and adolescence and increasing vulnerability to NDs.

Factor structure of self-reported clinical disorders and personality disorders: a review of the existing literature and a factor analytical study.

OBJECTIVES: The aim of this research is to add to the current understanding of the latent factor structure of personality disorders by performing a review of the existing literature (Study 1) and a factor analytical study on the factor structure and the relationship between self-reported Axis I and Axis II psychopathology (Study 2). DESIGN: The current research (Study 2) is cross-sectional and multicenter. RESULTS: We found support for the assumption that the borderline personality disorder is a multidimensional construct. Second, we found evidence for a single-factor structure of the narcissistic, dependent as well as the avoidant personality disorder. Third, we found support for the current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) distinction between Axis I and Axis II, Axis I psychopathology being explained by the factor neuroticism and Axis II disorders to be further subdivided into the higher order factors of internalizing and externalizing pathology. CONCLUSIONS: An adaptation to the current DSM-IV borderline personality criteria should be made, while various findings show that the borderline construct is multidimensional. Second, deletion of the dependent and narcissistic personality in the DSM-V might be unjust. Third, Axis I psychopathology can be explained by the factor neuroticism, and Axis II disorders should be further subdivided into the higher order factors of internalizing and externalizing pathology.

[Christa Kohler's "communicative psychotherapy" as an integrated psychotherapeutic concept and its biographical, scientific and historical context]. / Christa Kohlers "Kommunikative Psychotherapie"--ein integratives Psychotherapiekonzept im biografischen, wissenschaftlichen und historischen Kontext.

"Communicative psychotherapy" was developed in the 1960s by the East German psychotherapist and psychiatrist Christa Kohler (1928-2004) for the treatment of "neuroses". Similar to established present-day psychotherapeutic methods, such as cognitive behaviour therapy, it combined diverse therapeutic approaches into an integrated treatment programme. This included individual and group therapy, exercise, work and occupational therapy. In contrast to modern psychotherapeutic practice, communicative psychotherapy was based on a firm system of values, namely socialist ideals. According to this system, psychological breakdown was viewed and treated ideologically. In addition, any lack of conformity with the East German system was likewise regarded as a psychopathological deviation, which should be subjected to psychological treatment. The latter concept requires a critical analysis from a current-day perspective. For the first time, this paper concentrates on Kohler's work on neuroses and the theory and practice of her communicative psychotherapy, albeit without neglecting Kohler's other scientific works, her biographical information and her Stasi documents.

Self-estimates of intelligence: interaction effects of the comparison to a specific reference group and neuroticism.

An experiment that investigated the interaction effect of Neuroticism and the comparison to different reference groups on self-estimates of intelligence is reported. University students (100 men, 15 women) were randomly assigned to two experimental groups and asked to rate their own intelligence on a one-item measure, in IQ points, having been provided with reference values for either the general population or a student sample. Analysis of data confirmed that the accuracy of self-estimates of intelligence was influenced by the variation of the instruction. Participants provided more accurate estimations when confronted with comparison information about fellow students than about the general population. Persons scoring high on Neuroticism estimated their intelligence lower, but only when their estimation was based on a general reference group. Theoretical and practical implications were discussed.

Trait empathy as a predictor of individual differences in perceived loneliness.

Loneliness has been shown to be inversely correlated with empathy in younger adults. The present study extends previous research by investigating the association between empathy and loneliness across the adult lifespan and examining the role of relevant demographic and personality factors. 110 community-dwelling adults (18 to 81 years old) completed the UCLA Loneliness Scale and the Empathy Quotient. Empathy scores were inversely associated with rated loneliness and predicted 8.7% of variance in loneliness scores after accounting for sex, age, relationship status, education, and neuroticism. The Social Skills factor of the Empathy Quotient was the strongest predictor of the association between perceived empathy and loneliness. Previous research is extended by the finding that rated loneliness was inversely associated with empathy scores across the adult lifespan. Underlying this relationship may be negative perceptions of personal social proclivity as a function of difficulty in understanding the mental states of others and high trait neuroticism.

Change in self-concept differentiation after psychotherapy and its relation to psychological maladjustment.

The research was carried out with a group of 105 psychotherapy participants, diagnosed with neurosis or personality disorders, and 36 controls. Analysis supported the hypotheses that self-concept differentiation (SCD) decreases after psychotherapeutic interventions and that the reduction in SCD is positively correlated with an improvement in neurotic symptoms and neurotic personality traits.

Personality and mental health: Arabic Scale of Mental Health, Eysenck Personality Questionnaire, and Neo Five Factor Inventory.

The aim of this research was to explore associations of mental health and personality factors through two studies. Two separate convenience samples of volunteer Kuwaiti college students took part in the study (n1 = 193, n2 = 128). Their ages ranged between 18 and 32 years. They responded, in small group sessions, to the Eysenck Personality Questionnaire and to Costa and McCrae's Five Personality Factors in their Arabic forms. In addition, both samples responded to the Arabic Scale of Mental Health (ASMH). In the first study, scorers on the ASMH were significantly correlated (r) with Neuroticism (-.63), Extraversion (.57), and Lie (.22) scores. Two orthogonal components were retained and labeled "Mental health and Extraversion versus Neuroticism," and "Psychoticism versus Lie." In Study 2, mental health scores were significantly positively correlated with Conscientiousness (.62), Extraversion (.59), Agreeableness (.34), and Openness (.26) scores, and negatively with Neuroticism (-.62) scores. Two orthogonal components were retained and labeled "Mental health, Agreeableness, Extraversion versus Neuroticism," and "Openness, Conscientiousness, and Mental health." It was concluded that the salient associations of the ASMH were with positive traits and scores on Extraversion, Conscientiousness (positive), and with Neuroticism (negative), indicating good construct validity of the ASMH.