No association between serotonin 2A receptor gene variants and personality traits.

Among theories of biological underpinnings to personality traits, different mechanisms of the serotonergic system are perhaps the most common factors suggested to influence individual differences in personality traits. We have investigated two frequent variants in the serotonin 2A receptor gene (5-HT2A) and personality traits. Healthy Swedish subjects (n = 304) were assessed with the Karolinska Scales of Personality (KSP) inventory. After correction for multiple testing, no significant differences were found. We conclude that the investigated 5-HT2A gene variants do not significantly influence personality as assessed by the KSP in the present population.

Androgen receptor trinucleotide repeat polymorphism and personality traits.

Human family and twin studies have established considerable heritable components influencing individual differences in personality traits as assessed by self-report questionnaires. We have investigated a trinucleotide repeat polymorphism in the androgen receptor gene and personality traits. Healthy Swedish subjects (n = 335) were assessed with the Karolinska Scales of Personality inventory. There were tendencies (P > or = 0.006) in some scales indicating possible relationships between the androgen receptor allele length and personality traits related to dominance and aggression. However, after correction for multiple testing, no significant differences were found. We conclude that no significant association could be found between the androgen receptor polymorphism investigated and any personality trait, although the tendencies found are worthwhile subjects for replication attempts.

The central relationship questionnaire (CRQ): psychometric properties in a Swedish sample and cross-cultural studies.

The Core Conflictual Relationship Theme (CCRT) method is one of the most widely used and tested instruments developed within a psychoanalytic context for assessing central relationship patterns or characteristic patterns of relating to others. The Swedish version of the Central Relationship Questionnaire (CRQ), a recently developed self-report instrument based on the CCRT, was tested in a sample of Swedish psychology students (31 men, 60 women) and compared with responses of Swedish outpatients (15 men, 15 women) and North American students (49 men, 49 women). The subscales of the Swedish CRQ showed acceptable internal consistency and correlated with each other in a predictable fashion, displaying a pattern of intercorrelations similar to the English version. The CRQ showed meaningful patterns of correspondence with self-reported interpersonal problems as well as meaningful differences between the Swedish students and Swedish outpatients, indicating preliminary convergent and divergent validity.

Swedish universities Scales of Personality (SSP): construction, internal consistency and normative data.

OBJECTIVE: A thorough revision of the Karolinska Scales of Personality (KSP) was made by reducing the number of items and improving the psychometric quality as concerns face validity, internal consistency and response differentiation. The revised version was labelled The Swedish universities Scales of Personality (SSP) and now include 91 items divided into 13 scales. METHOD: The SSP were evaluated in a normative, randomly drawn sample (n = 741). All scales were found to be approximately normally distributed. RESULTS: The Cronbach's alpha coefficients ranged from 0.59 to 0.84. The mean inter-item correlations (MIIC) ranged from 0.17 to 0.43. The scale intercorrelation matrix yielded a three-factor solution with Factor 1 reflecting Neuroticism; Factor 2 Aggressiveness; and Factor 3 reflecting Extraversion. CONCLUSION: The original KSP scales were revised, shortened, modernized and psychometrically evaluated. The psychometric properties and the usefulness of the test battery were found to be substantially improved.

A promoter polymorphism in the monoamine oxidase A gene and its relationships to monoamine metabolite concentrations in CSF of healthy volunteers.

Concentrations of monoamine metabolites (MM) in lumbar cerebrospinal fluid (CSF) have been used extensively as indirect estimates of monoamine turnover in the brain. We investigated possible relationships between a putative functional promoter polymorphism in the monoamine oxidase A (MAOA) gene and CSF concentrations of homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA), and 3-methoxy-4-hydroxyphenylglycol (MHPG) in healthy volunteers (n=88). Among women (n=37), those carrying at least one copy of the alleles associated with more efficient transcription displayed higher concentrations of HVA (p=0.01) and 5-HIAA (p=0.01). In men (n=51), however, there was a tendency in the opposite direction. The results suggest that MAOA genotypes may participate differentially in the regulation of dopamine and serotonin turnover rates under presumed steady state in the central nervous system. The results should be interpreted with caution until replicated because of the limited sample size.

After the MV Estonia ferry disaster A Swedish nationwide survey of the relatives of the MV Estonia victims.

Just after midnight on the 28th of September 1994, the Estonian-flagged ro-ro passenger ferry MV Estonia was shipwrecked on its route between Tallinn and Stockholm. Out of about 1000 persons on board only 137 survived. This paper describes the work that the Psychiatric Clinic at Ersta Hospital performed with the relatives of the MV Estonia victims after the disaster, in addition, we present data from seven consecutive Swedish nationwide surveys based on a questionnaire, which started as a correspondence between the hospital and the relatives of the Estonia victims. Findings concerning the care relatives received and issues regarding their collaboration with the decisionmaking authorities are presented. The importance of inviting the relatives to participate in discussions concerning the Estonia victims is stressed.

No association between serotonin transporter gene polymorphisms and personality traits.

Human family and twin studies have established considerable heritable components in personality traits as assessed by self-report questionnaires. Recently, an association between a functional polymorphism in the upstream regulatory region of the serotonin transporter gene and neuroticism-related personality traits was reported. Two different serotonin transporter polymorphisms including the previously associated variant were genotyped in two samples of healthy Swedish subjects (n = 127 and n = 178, respectively) assessed with the Karolinska Scales of Personality (KSP) inventory. No statistically significant association between serotonin transporter polymorphisms and any of the eight neuroticism-related KSP scales was found. Thus, the previously reported association between serotonin transporter alleles and neuroticism-related personality traits could not be replicated in the present study.

Lack of association between dopamine D4 receptor gene and personality traits.

BACKGROUND: Personality traits have shown considerable heritable components. Association between alleles of a polymorphism in the third exon of the dopamine D4 receptor gene (DRD4) and the personality trait Novelty Seeking has been reported. Recently, in a sample of Swedish non-psychiatric subjects we could not detect any significant relationships between the same polymorphism and Novelty Seeking related scales in the Karolinska Scales of Personality (KSP). However, there was a tendency in the direction of the proposed association. There were also tentative associations between an exon I 13 bp deletion polymorphism and the personality traits Socialization and Guilt. METHODS: We investigated a new Swedish population-based sample (N = 167) investigated with the KSP for three DRD4 polymorphisms. RESULTS: Neither of the previous results were replicated. Combining the previous and the present samples did not give rise to any significant association between DRD4 polymorphisms and personality scales. CONCLUSIONS: The dopamine D4 receptor gene is probably not of importance to the different personality dimensions as measured by the Karolinska Scales of Personality.

Polymorphisms in the dopamine, serotonin, and norepinephrine transporter genes and their relationships to monoamine metabolite concentrations in CSF of healthy volunteers.

Concentrations of monoamine metabolites (MM) in lumbar cerebrospinal fluid (CSF) have been used extensively as indirect estimates of monoamine turnover in the brain. We investigated the possible relationships between DNA polymorphisms in the dopamine transporter (DAT), serotonin transporter (SERT), and norepinephrine transporter (NET) genes and CSF concentrations of homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA), and 3-methoxy-4-hydroxyphenylglycol (MHPG) in healthy volunteers (n = 66). The DAT polymorphism was not significantly associated with any of the monoamine metabolites, but a tendency for relationship with 5-HIAA was found in women. For both of the two SERT polymorphisms investigated, a functional promoter polymorphism and an intronic polymorphism without known function, significant relationships were found with CSF MHPG levels. No relationship was found between the SERT polymorphisms and CSF HVA and 5-HIAA. The NET polymorphism was associated with CSF MHPG levels but not HVA and 5-HIAA concentrations. The results suggest that SERT and NET genotypes may participate differentially in the regulation of the norepinephrine turnover rate under presumed steady-state conditions in the central nervous system. As only limited data so far indicate interactions between the serotonin and norepinephrine systems in the brain, and the NET polymorphism investigated is not known to be of functional significance, the results should be interpreted with caution until replicated.

Reliability of the Karolinska Psychodynamic Profile (KAPP) among patients with and without psychoactive substance abuse disorders.

BACKGROUND: The Karolinska Psychodynamic Profile (KAPP) is a rating instrument, based on psychoanalytic theory, that assesses different aspects of character from clinical interviews. The aim of the present study was to examine interrater reliability of the KAPP in a sample of patients with and without psychoactive substance abuse disorders, using interviewers and a reliability judge who had not been trained by the developers of the instrument. METHODS: The sample comprised 47 consecutive patients with and without psychoactive substance abuse disorders, who were referred to an outpatient psychotherapy unit specializing in the treatment of substance abuse and dependence. The two interviewers and the reliability judge had not been trained by the developers of the KAPP, and they worked outside the setting where it was constructed. RESULTS: The intraclass correlations were satisfactory for the total sample (mean 0.84, median 0.89, range 0.62-0.95), as well as for various sub-samples, such as males and females, and patients with and without substance abuse disorders. CONCLUSIONS: The results show that interviewers and a reliability judge who had not been trained by the developers of the KAPP can attain high interrater reliability in a sample of patients with substance abuse disorders. Some recommendations for conducting KAPP interviews are given.

The healthy control subject in psychiatric research: impulsiveness and volunteer bias.

Exciting and demanding biomedical experiments may attract a specific subgroup of people as volunteers. In the present study of selection bias, subjects volunteering in a psychobiological study that included a potentially painful procedure (lumbar puncture) were compared with those who declined to participate, with regard to scores on personality scales administered during a previous investigation of the same subjects. Significant differences were found on the Eysenck Personality Questionnaire and Karolinska Scales of Personality Impulsiveness scale, suggesting an over-representation of impulsive individuals among the volunteers. If the specific subject of investigation has implications for the type of individual who will participate as a healthy volunteer in biomedical research, variation will be introduced, affecting the independent variable, and the conclusions that can be drawn from such research may be questionable.

Lack of evidence for allelic association between personality traits and the dopamine D4 receptor gene polymorphisms.

OBJECTIVE: Personality traits in human subjects have shown considerable heritable components. Recently, two research groups reported associations between dopamine D4 receptor genotypes and the personality trait known as novelty seeking. This study was an attempt to replicate these findings. METHOD: Three different exonic dopamine D4 receptor polymorphisms were genotyped in 126 healthy Swedish subjects. Personality traits of the subjects were assessed with the Karolinska Scales of Personality. RESULTS: Although there was a tendency in the direction hypothesized, no significant association between genotype constellations and personality traits was found. CONCLUSIONS: The previously reported association between dopamine D4 receptor alleles and novelty seeking was not replicated. Possible reasons for this include differences in personality inventories, ethnicity, and type I or type II errors.

Attitudes of psychiatric nursing personnel towards patients who have attempted suicide.

The aim of this study was to examine the attitudes towards suicidal patients of a group of psychiatric nursing personnel (n = 197) and to establish a baseline of attitudinal measures against which the effects of a subsequent educational programme can be assessed. A scale, known as the Understanding of Suicide Attempt Patient Scale (USP Scale) was developed for this purpose. The reliability of the scale was satisfactory, and its correlation with visual analogue scale (VAS) scores based on clinical vignettes suggests that it has validity. Women tended to be more sympathetic than men, and older personnel were more favourably disposed than the younger nurses. Differences between personnel working in different settings were found, which might be explained by differences in the frequency of contact with suicide-prone patients, more frequent exposure being associated with more positive attitudes.

A prospective study of personality as a predictor of quality of life after pelvic pouch surgery.

BACKGROUND: Surgeons often "know" preoperatively which patients will achieve good postoperative quality of life (QOL). This intuition is probably based on impressions of the patient's personality. The present aim was to examine whether preoperative personality traits predict postoperative QOL. METHODS: In 53 patients undergoing pelvic pouch surgery for ulcerative colitis the relationship between preoperative personality traits, and surgical functional outcome and QOL was examined at a median of 17 months postoperatively. Personality assessment instruments (KAPP and KSP), and specific measures of alexithymia were used. Postoperatively, the Psychosocial Adjustment to Illness Scale (PAIS), and surgical functional outcome scales were used. RESULTS: Using multiple correlation/regression, analysis lack of alexithymia, poor frustration tolerance, anxiety proneness, and poor socialization (resentment over childhood and present life situation) were found to predict poor postoperative QOL. CONCLUSIONS: The findings suggest personality traits, in addition to surgical functional outcome, to be important for the patient's postoperative QOL.

Tryptophan hydroxylase and catechol-O-methyltransferase gene polymorphisms: relationships to monoamine metabolite concentrations in CSF of healthy volunteers.

Concentrations of monoamine metabolites (MM) in lumbar cerebrospinal fluid (CSF) have been used extensively as indirect estimates of monoamine turnover in the brain. We investigated possible relationships between DNA polymorphisms in the tryptophan hydroxylase (TPH) and catechol-O-methyltransferase (COMT) genes and CSF concentrations of 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA), and 3-methoxy-4-hydroxyphenylglycol (MHPG) in healthy volunteers (n = 66). Lower CSF 5-HIAA levels were found in men with the TPH U allele (p = 0.005), but not in women. A similar but less significant pattern was observed for CSF HVA. No relationship was found between the TPH polymorphism and CSF MHPG. COMT genotypes did not relate significantly to MM concentrations. The results suggest that TPH genotypes participate differentially in the regulation of serotonin turnover rate under presumed steady state in the central nervous system of men. Due to the uncertain functional relevance of the DNA polymorphism investigated and the many calculations performed, the results should be interpreted with caution until replicated.

Suicidal feelings and work environment in psychiatric nursing personnel.

Suicidal feelings, attempted suicide and aspects of work environment and well-being in Swedish psychiatric nursing personnel were studied using a questionnaire. The questionnaire, containing 190 questions, was mailed to all 242 nurses and attendants working in psychiatric care at the department of psychiatry at Karolinska Hospital. Eighty-one percent (n = 197) returned the questionnaire. Suicidal feelings "last year" were lower than in the general population, but suicidal feeling and attempted suicide "earlier than last year" were much more common, and 13% reported that they had attempted suicide earlier in life. In order to study the possible association between work environment and suicide, a factor analysis was performed. Four factors were extracted and labelled: suicidality, quality of work, negative work environment and burn out/depression. The correlation between the factors suggests that negative work environment is associated with burn out/depression, which in turn is related to suicidality. No direct link was demonstrated between suicidality and work environment, and completed suicide was not investigated. The study provides some indirect evidence that a negative work environment may increase suicidal feelings.

Personality predictors of dimensions of psychosocial adjustment after surgery.

OBJECTIVE: Although many studies have examined the relationship between personality factors and adjustment after surgery, most of them have had very short follow-up periods. The present prospective study examines whether preoperative psychodynamic assessment of personality traits enhances prediction of various areas of psychosocial adjustment assessed at least 1 year after surgery. METHODS: In 53 patients undergoing pelvic pouch surgery for ulcerative colitis, we examined the relationship between personality traits measured before surgery, and postoperative psychosocial adjustment assessed at a median of 17 months postoperatively, controlling for the effect of surgical functional outcome. Personality traits were assessed with the Karolinska Psychodynamic Profile (KAPP). Surgical functional outcome scales and the Psychosocial Adjustment to Illness Scale (PAIS) were used. RESULTS: Problems with sexual satisfaction, perfectionistic body ideals, lack of alexithymia, and poor frustration tolerance predicted poor postoperative adjustment in various areas, beyond what was predicted by surgical functional outcome alone. Moreover, moderate preoperative levels of alexithymia were beneficial to postoperative adjustment in the area of psychological distress. CONCLUSIONS: The findings suggest that the preoperative assessment of the patient's long-term sexual functioning and satisfaction, the importance attached to his or her appearance, level of alexithymia, and general capacity to tolerate frustration and set-backs in life, might alert both the surgeon and the patient to potential risk factors for poor postsurgical adjustment.

Dopamine-related genes and their relationships to monoamine metabolites in CSF.

Monoamine metabolite (MM) levels in lumbar cerebrospinal fluid (CSF) are extensively used as indirect estimates of monoamine turnover in the brain. In this study we investigated genotypes for DNA polymorphisms in the D2 (DRD2), D3 (DRD3), and D4 (DRD4) dopamine receptor and tyrosine hydroxylase (TH) genes and their relationships to CSF MM in healthy volunteers (n = 66). Concentrations of homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylglycol (MHPG), and 5-hydroxyindoleacetic acid (5-HIAA) were corrected for back length, a confounding variable. Corrected MM levels were not related to age, gender, height, weight heredity, season or atmospheric pressure at sampling. Individuals with specific DRD2 and TH allele and genotype configurations significantly differed in HVA and MHPG concentrations. DRD3 homo- and heterozygotic genotypes had significantly different CSF 5-HIAA levels. DRD4 genotypes were not related to MM concentrations. The results suggest that specific DRD2, DRD3, and TH genotypes participate in the regulation of monoamine turnover in the central nervous system. Accordingly monoamine receptors and synthesizing enzyme genotypes appear to be variance factors influencing MM concentrations in CSF. The relationships found in this study support MM concentrations as markers for monoamine transmission in the human brain.