When personality and culture clash: the psychological distress of allocentrics in an individualist culture and idiocentrics in a collectivist culture.

Because humans need both autonomy and interdependence, persons with either an extreme collectivist orientation (allocentrics) or extreme individualist values (idiocentrics) may be at risk for possession of some features of psychopathology. Is an extreme personality style a risk factor primarily when it conflicts with the values of the surrounding society? Individualism-collectivism scenarios and a battery of clinical and personality scales were administered to nonclinical samples of college students in Boston and Istanbul. For students residing in a highly individualistic society (Boston), collectivism scores were positively correlated with depression, social anxiety, obsessive-compulsive disorder and dependent personality. Individualism scores, particularly horizontal individualism, were negatively correlated with these same scales. A different pattern was obtained for students residing in a collectivist culture, Istanbul. Here individualism (and especially horizontal individualism) was positively correlated with scales for paranoid, schizoid, narcissistic, borderline and antisocial personality disorder. Collectivism (particularly vertical collectivism) was associated with low report of symptoms on these scales. These results indicate that having a personality style which conflicts with the values of society is associated with psychiatric symptoms. Having an orientation inconsistent with societal values may thus be a risk factor for poor mental health.

Neurocognitive function in borderline personality disorder.

A battery of neuropsychological measures considered sensitive to dysfunction in prefrontal or temporal cortices was administered to patients with borderline personality disorder (BPD) and healthy controls. BPD patients exhibited striking deficits on measures of nonverbal executive function and nonverbal memory but were unimpaired on tests of alternation learning, response inhibition, divergent thinking, verbal fluency, and verbal working memory. A second study found that university students obtaining high scores on a self-report measure of BPD symptoms exhibited a similar pattern of neuropsychological impairment, although performance deficits were much less pronounced in the student sample. Taken together, these studies suggest that dysfunction of a right hemisphere frontotemporal regions may be associated with borderline personality.

Cigarette smoking in a student sample: neurocognitive and clinical correlates.

Why do adolescents begin to smoke in the face of profound health risks and aggressive antismoking campaigns? The present study tested predictions based on two theoretical models of tobacco use in young adults: (1) the self-medication model; and (2) the orbitofrontal/disinhibition model. Investigators speculated that a significant number of smokers were self-medicating since nicotine possesses mood-elevating and hedonic properties. The self-medication model predicts that smokers will demonstrate increased rates of psychopathology relative to nonsmokers. Similarly, researchers have suggested that individuals with attention-deficit/hyperactivity disorder (ADHD) employ nicotine to enhance cognitive function. The ADHD/self-medication model predicts that smokers will perform poorly on tests of executive function and report a greater number of ADHD symptoms. A considerable body of research indicates that tobacco use is associated with several related personality traits including extraversion, impulsivity, risk taking, sensation seeking, novelty seeking, and antisocial personality features. Antisocial behavior and related personality traits as well as tobacco use may reflect, in part, a failure to effectively employ reward and punishment cues to guide behavior. This failure may reflect orbitofrontal dysfunction. The orbitofrontal/disinhibition model predicts that smokers will perform poorly on neurocognitive tasks considered sensitive to orbitofrontal dysfunction and will obtain significantly higher scores on measures of behavioral disinhibition and antisocial personality relative to nonsmokers. To test these predictions, we administered a battery of neuropsychological tests, clinical scales, and personality questionnaires to university student smokers and nonsmokers. Results did not support the self-medication model or the ADHD/self-medication model; however, findings were consistent with the orbitofrontal/disinhibition model.

Patterns of Axis-II comorbidity in a Turkish OCD sample.

OBJECTIVE Obsessive-compulsive disorder (OCD) patients frequently present with Axis-II disorders, particularly Cluster C (anxiety spectrum) and Cluster A (schizophrenic spectrum) personality disorders. The present study examined patterns of Axis-II comorbidity in a Turkish OCD sample. In addition, we explored the impact of personality disorder symptoms on OCD-symptom severity and symptom profile. METHOD Structured psychiatric interviews and self-report measures of OCD symptoms and Axis-II disorders were administered to patients with OCD and control subjects. RESULTS Patients with OCD obtained significantly higher scores on measures of Cluster A and Cluster C personality disorders. Patients with OCD also achieved significantly higher scores on the BPD Subscale; however, they did not obtain significantly higher scores on other Cluster B subscales. Group differences on measures of Cluster A and C disorders were marked. CONCLUSIONS Findings are consistent with prior work demonstrating an increased incidence of Axis-II disorders among patients with OCD.

Neuropsychological function in obsessive-compulsive disorder: effects of comorbid conditions on task performance.

BACKGROUND: Neuropsychological testing reveals a pattern of impairment among patients with obsessive-compulsive disorder (OCD) which implicates the orbitofrontal region. Studies of neuropsychological function in OCD differ regarding performance deficits on classical tests of frontal executive function. In some studies, OCD patients did not demonstrate impaired performance on tests of executive function. However, other researchers have documented performance deficits among OCD patients on measures of executive function. Patients with OCD also exhibit performance deficits on tests of visual/spatial memory and verbal memory. Again, in some studies, OCD patients did not demonstrate impaired performance on tests of memory function. How can we account for the conflicting findings? One possibility is that performance deficits on tests of cognitive function are associated with comorbid conditions. In prior work, we observed that OCD patients who did poorly on executive function tasks obtained high scores on a measure of schizotypal personality. A second possibility is that executive function deficits among patients with OCD are associated with comorbid depressive symptoms. METHOD: In the present study, a comprehensive neuropsychological test battery was administered to patients with OCD and matched healthy control subjects. We also administered dimensional measures of schizotypal personality and depression to patients with OCD and controls. We conducted analyses of covariance (ANCOVA), with scores on measures of schizotypal personality and depression used as covariates. RESULTS: OCD patients demonstrated performance deficits on measures of delayed memory, response inhibition, alternation learning, and obtained significantly higher scores on measures of disinhibition, impulsivity, and temporolimbic symptoms; however, OCD patients did not exhibit impaired performance on tests of executive function and verbal fluency, and did not report a significantly greater number of dysexecutive symptoms, when coexistent depressive and schizotypal symptoms were taken into account. CONCLUSION: Findings are consistent with the contention that dysfunction of an orbitofrontal-limbic network underlies OCD.

Assessing adult attention-deficit/hyperactivity disorder: a Turkish version of the current symptoms scale.

We report normative data for a Turkish translation of the Current Symptoms Scale (CSS), a screening measure of adult attention-deficit/hyperactivity disorder (ADHD). The CSS yields 3 scores reflecting diagnostic criteria for: (1) ADHD, predominantly hyperactive-impulsive type; (2) ADHD, predominantly inattentive type, and (3) ADHD, combined type. For comparison purposes, we also present normative data from a community sample in the United States. Central tendency, variability, and correlation patterns among Turkish subjects (n=181) were similar to patterns demonstrated by respondents in the United States (n=114). Mann-Whitney U tests revealed that the Turkish and US groups did not differ significantly on the subscales assessing inattentive and hyperactive-impulsive symptoms. Both versions demonstrated acceptable levels of internal consistency (Cronbach's alpha coefficients ranged from 0.65 to 0.78 for the Turkish version, and from 0.63 to 0.75 for the English version). The Turkish version of the CSS demonstrated excellent test- retest reliability. The test-retest coefficient for the CSS (total score) was 0.82. The inattentive type subscale also showed good test-retest reliability, with r=0.78. The test-retest coefficient for the hyperactive-impulsive type subscale was appreciably lower, with r=0.68; albeit, in the acceptable range. Investigators have determined that many adults, initially diagnosed with ADHD as children, continue to demonstrate clinically significant symptoms. Since adult ADHD is associated with a number of comorbid psychiatric conditions and treatment of the underlying attentional, executive, and impulse control difficulties is associated with a reduction in comorbid psychiatric symptoms, the routine screening for adult ADHD in psychiatric and mental health settings may be warranted.

Effects of bilingual and monolingual presentations and time on concept- and language-matching tasks.

Balanced Turkish-English bilingual participants viewed word pairs, presented both monolingually (English-English or Turkish-Turkish) or bilingually (English-Turkish or Turkish-English) and both for short and long durations. They made decisions on whether the simultaneously presented words in a pair were in the same language or not, or whether they denoted the same concept or not. In the short presentation condition, we found no evidence for subliminal processing. In cases in which both words were consciously identified, participants were more accurate, although not faster in the long than in the short presentation condition for both language and concept decisions. In the long presentation condition, language decisions were more accurate than concept decisions, although not faster. In addition, language decisions were not affected by whether the words were synonyms (concept identity), and concept decisions were not affected by whether the presentation was monolingual or bilingual (language identity), although in the monolingual conditions, "same" decisions were faster but not more accurate, and in the bilingual conditions a speed-accuracy trade-off was observed in that "same" decisions were faster but "different" decisions were more accurate.

Positive and negative schizotypy in a student sample: neurocognitive and clinical correlates.

Positive and negative schizotypy may represent discrete factors or dimensions. To determine if distinct neurocognitive profiles are associated with these dimensions or factors, we classified university students on the basis of positive and negative schizotypal symptoms and conducted separate analyses. Following prior work in the neuropsychiatric literature, we predicted that subtle prefrontal deficits would be selectively associated with negative schizotypal personality features in a nonclinical student sample. We also investigated the relationship between positive/negative schizotypy and associated clinical states or personality dimensions including antisocial personality disorder, obsessive-compulsive personality traits, generalized and social anxiety, empathy, and impulsivity. Classification of subjects into positive and negative schizotypy groups revealed distinct neurocognitive and clinical profiles. We observed a positive relation between measures of temporolimbic dysfunction, impulsivity, antisocial behavior, and positive schizotypal phenomena. Negative schizotypy was associated with subtle performance deficits on measures of frontal executive function, increased social anxiety, and obsessive-compulsive phenomena. Findings are consistent with the contention that positive and negative schizotypy represent discrete factors.