The role of personality in posttraumatic stress disorder, trait resilience, and quality of life in people exposed to the Kiss nightclub fire.

OBJECTIVE: To evaluate the relationship among personality (according to Cloninger's psychobiological model), posttraumatic stress disorder (PTSD) symptoms, trait resilience and quality of life (QoL) in people who were exposed to the Kiss nightclub fire. METHODS: 188 participants were assessed with the Posttraumatic Checklist-civilian version (PCL-C), the Resilience Scale (RS), the Temperament and Character Inventory (TCI), the World Health Organization Quality of Life-Bref (WHOQOL-Bref), and the WHOQOL-100 Spirituality, religiousness, and personal beliefs (WHOQOL-100-SRPB). Data were analyzed in a dimensional approach, with correlation analysis, multiple linear regression and Structural Equation Modeling (SEM), with PCL-C, RS, and WHOQOL-Bref dimensions as dependent variables. RESULTS: Multiple linear regression showed that PTSD symptoms were predicted by harm avoidance (ß = .34, p < .001), self-directedness (ß = -.28, p < .01), and self-transcendence (ß = .24, p < .01). Trait resilience was predicted by harm avoidance (ß = -.38, p < .01), self-directedness (ß = .20, p < .05), and self-transcendence (ß = .18, p < .05). Also, PTSD symptoms had considerable negative effect on all dimensions of QoL. Self-transcendence was a positive predictor of subjective and spiritual QoL. SEM showed that QoL was predicted by PTSD symptoms (ß = -.52, p < .001), trait resilience (ß = .30, p < .001), cooperativeness (ß = .135, p = 0.40), and self-directedness (ß = .27, p < .01). The effect of self-directedness on QoL was mediated by PTSD symptoms and trait resilience. PTSD symptoms also mediated the relationship between trait resilience and QoL, and RS mediated the relationship of personality and PTSD symptoms. CONCLUSION: The study gives insights on prediction of PTSD severity, trait resilience and QoL from temperament and character traits, in a sample of people exposed to the Kiss nightclub fire. Harm avoidance was the most influent trait on PTSD symptoms and trait resilience. Self-directedness was the most import trait related to QoL, still that it was more related to PTSD severity than personality traits. Self-transcendence had positive effects on both PTSD symptoms and trait resilience, indicating a coping style that may coexist with psychopathology.

Involuntary psychiatric hospitalization and its relationship to psychopathology and aggression.

The current study investigates the relationship between involuntary hospitalization, severity of psychopathology, and aggression. Adult psychiatric inpatients hospitalized from August, 2012 to January, 2013 were evaluated via the Brief Psychiatric Rating Scale (BPRS) and the Overt Aggression Scale (OAS). Individuals were compared regarding voluntariness of hospitalization. Of the 137 hospitalizations in the period, 71 were involuntary (INV). The variables associated with involuntariness were being brought to hospital by ambulance or police, and aggression in the first 24 h of admission. Risk of suicide at admission, and having personal income were associated with voluntariness. The dimensions of the BPRS associated with involuntary hospitalization were activation, resistance, and positive symptoms. Involuntary psychiatric hospitalization was associated with agitation, psychosis and aggression. The data support the indication of involuntary hospitalization for treatment of patients with severe mental illness.