Thesis (Ph. D.)--State University of New York at Binghamton, Department of Psychology, 2006. / Includes bibliographical references.

Thesis (Ph.D. in counseling)--Liberty University, 2006. / Includes bibliographical references.

Thesis (M.S.)--Florida State University, 2004. / Advisor: Dr. Joyce L. Carbonell, Florida State University, College of Arts and Sciences, Dept. of Psychology. Title and description from dissertation home page (viewed Jan. 14, 2005). Includes bibliographical references.

Thesis (Ph. D.)--University of Texas at Austin, 2004. / Supervisors: Deborah J. Tharinger and Timothy Z. Keith. Vita. Includes bibliographical references. Also available from UMI.

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 1997. / Vita. Includes bibliographical references (leaves 145-152).

Thesis (Psy.D.) -- Virginia Consortium for Professional Psychology. / Includes bibliography.

Thesis (Ph.D.) - University of Queensland, 2003. / Includes bibliography.

The purpose of this study is to replicate and extend earlier work involving cluster analysis of MMPI profiles among persons with chronic low back pain. There are two specific goals. The first goal is to demonstrate the existence in a new sample of four distinct and homogenous profile clusters that have been found in previous research. The second goal is to investigate the relationship of the four profiles to the subjects, self-reported pain history and response to treatment. This study concludes that four distinct MMPI profiles can be identified among chronic low back pain patients. Further, these profiles are the same for males and females, and are the same profiles found in previous research. These profiles are significantly related to subjects' history of behaviors in dealing with pain. However, no relationship to treatment response was found. It was inferred that the MMPI is of value in understanding the nature of patients' pain coping behaviors, but that further research is needed before any statements can be made regarding the utility of the MMPI in understanding their response to treatment.

INTRODUÇÃO: Fibromialgia tem sido considerada uma síndrome, na qual a etiologia e etiopatogenia ainda permanecem pouco esclarecidas. Transtornos depressivos e ansiosos são altamente prevalentes nesses pacientes, entretanto, em relação aos aspectos da personalidade, os dados de literatura são pouco homogêneos. Poucos estudos têm investigado a relevância de fatores emocionais, incluindo aspectos da personalidade, como preditores para intensidade da dor em fibromialgia. Cloninger desenvolveu uma teoria da personalidade integrando os aspectos biológicos e psicológicos, estruturando o Inventário de Temperamento e Caráter para investigar quatro traços de temperamento (esquiva ao dano, busca de novidades, dependência de gratificação e persistência) e três traços de caráter (auto-direcionamento, cooperatividade e auto-transcendência). Estudos sugerem que o Inventário de Temperamento e Caráter possui valor preditivo, assim alterações nos traços esquiva ao dano e autodirecionamento poderiam predizer vulnerabilidade para alguns transtornos. Este estudo teve como objetivo principal investigar o valor preditivo do fator esquiva ao dano para intensidade da dor em pacientes com fibromialgia após o período de um ano a um ano e seis meses (T2) da primeira avaliação (T1). Os objetivos secundários deste estudo foram: comparar os escores de esquiva ao dano e os demais traços do Inventário de Temperamento e Caráter entre mulheres com fibromialgia e um grupo controle de mulheres sem a doença. Considerando apenas o grupo de pacientes com fibromialgia, o estudo investigou diferenças nos traços do Inventário de Temperamento e Caráter entre as pacientes com depressão maior atual e pacientes sem depressão maior atual. MÉTODOS: O estudo foi desenvolvido entre abril de 2006 e setembro de 2009 em duas etapas: transversal e prospectiva. Na etapa transversal, 78 mulheres foram comparadas no fator esquiva ao dano com 78 mulheres do grupo controle. Os dois grupos foram avaliados em suas características sócio-demográficas e clínicas, sintomatologia depressiva (Inventário de depressão de Beck e HAM-D) e ansiosa (IDATEestado e HAM-A) e diagnóstico de transtornos mentais (M.I.N.I.). O grupo de pacientes também foi avaliado em relação à intensidade da dor e tempo de fibromialgia. Na etapa prospectiva, 42 pacientes foram reavaliadas em suas características clínicas e sócio-demográficas, intensidade da dor, diagnóstico de depressão maior atual e sintomas depressivos e ansiosos. RESULTADOS: Na comparação dos escores do fator esquiva ao dano, as pacientes apresentaram maior média que o grupo controle, e após análise covariância essa diferença foi explicada pela sintomatologia depressiva e ansiosa. Em relação aos outros traços de personalidade, as pacientes apresentaram maiores médias no fator auto-transcendência e menores médias nos fatores busca de novidades, dependência de gratificação, auto-direcionamento e cooperatividade quando comparadas com o grupo controle. Essas diferenças, após análise de covariância, se associaram com sintomas depressivos e ansiosos. Entretanto, as pacientes com fibromialgia mantiveram menores escores no fator busca de novidades mesmo com o ajuste para a sintomatologia depressiva e ansiosa. No grupo de pacientes, o fator esquiva ao dano não se correlacionou com intensidade da dor e tempo de doença. As pacientes com fibromialgia e depressão maior atual apresentaram maiores escores em esquiva ao dano, e menores escores em auto-direcionamento e cooperatividade quando comparadas com as pacientes sem depressão. Na etapa prospectiva, o fator esquiva ao dano não apresentou valor preditivo para intensidade ou variação da dor. Além disso, nenhum dos outros traços de personalidade se correlacionou com a intensidade ou com a variação da dor de T1 para T2. CONCLUSÕES: Os resultados deste estudo indicam que embora pacientes com fibromialgia apresentem maior pontuação no fator esquiva ao dano do Inventário de Temperamento e Caráter quando comparadas com mulheres sem a doença, essa diferença se deve a maior intensidade de sintomas depressivos e ansiosos nas pacientes e não à presença da fibromialgia em si. As diferenças encontradas nos traços de personalidade entre as pacientes com depressão e pacientes sem depressão sugerem que a depressão nessas pacientes possui, em parte, semelhanças com transtorno depressivo maior (depressão primária). Em relação à etapa prospectiva, os resultados indicam que o fator de temperamento esquiva ao dano não apresenta valor preditivo para intensidade da dor ou para variação da dor em mulheres com fibromialgia / INTRODUCTION: Fibromyalgia has been considered as a syndrome that the etiology and etiopathogeny remains unclear. Depressive and anxiety disorders are very common in fibromyalgia patients. However data about the relationship between personality characteristics and fibromyalgia are less homogeneous. Few studies have investigated the relevance of emotional factors including personality aspect as predictors of pain intensity in fibromyalgia. Cloninger developed a theory unifying psychological and biological aspects of personality, and created the Temperament and Character Inventory, to evaluate four temperament traits (harm avoidance, novelty seeking, reward dependence and persistence) and tree character traits (self-directedness, cooperativeness and self-transcendence). Studies have suggested that the Temperament and Character Inventory presents a predictive value, thus alterations on harm avoidance and self-directedness could predict vulnerability to some disorders. The main objective of this study was to investigate the predictive value of harm avoidance for pain intensity in fibromyalgia patients after the period of one year to one year and six months (T2) from the first evaluation (T1). The secondary objectives were: to compare the harm avoidance temperament trait and the others traits of the Temperament and Character Inventory in fibromyalgia women with a control group without this diagnose. In the fibromyalgia group, the objectives were to compare the Temperament and Character Inventory traits between fibromyalgia patients with major depressive episode and fibromyalgia patients without this diagnose. METHOD: The study was developed between from June 2006 to September 2008 in two parts: transversal and prospective. In the transversal part 78 women with fibromyalgia were compared with 78 women without fibromyalgia. The two groups were evaluated in relation to socio-demographic and clinical characteristics, depressive (Beck Depression Inventory and HAM-D) and anxiety (IDATE-state and HAM-A) symptoms and psychiatric diagnoses (M.I.N.I.). The fibromyalgia patients were also evaluated regarding the disease duration and pain intensity. In the prospective part 42 patients were revaluated regarding socio-demographic and clinical characteristics, pain intensity, the presence of major depressive episode and anxiety and depressive symptoms. RESULTS: Fibromyalgia patients showed higher scores in harm avoidance than control group, after covariance analyze, this difference was explained by an increased severity of depressive and anxiety symptoms in the group with fibromyalgia. Comparing the other personality traits, patients with fibromyalgia showed increased scores in self-transcendence and low scores in novelty seeking, reward dependence, self-directness and cooperativeness when compared with those without fibromyalgia. After covariance analyze the difference between patients and control group were explained by an increased intensity of depressive and anxiety symptoms in patients with fibromyalgia. However, fibromyalgia patients maintained lower scores on novelty seeking even after adjustments for severity of depressive and anxiety symptom. Regarding the patients group, was not found an association between harm avoidance trait and disease duration or pain intensity. Patients with fibromyalgia and major depression episode showed increased scores in harm avoidance and low scores in self-directness and cooperativeness when compared with fibromyalgia patients without depression. In the prospective part the harm avoidance in T1 did not predict the pain intensity in T2 or pain variation from T1 to T2. There was no correlation between the other personality traits and pain intensity in T2 or pain variation from T1 to T2. CONCLUSION: The results of this study indicate that although women with fibromyalgia present higher scores in harm avoidance when compared with women without fibromyalgia, this difference is explained by an increased severity of depressive and anxiety symptoms in fibromyalgia patients and not because of fibromyalgia itself. The differences found in the personality traits between depressed fibromyalgia patients and non depressed patients suggest that depression in these patients is in part similar to the major depressive disorder (primary depression). Regarding the prospective part, the results indicate that the temperament trait harm avoidance does not have a predictive value for the pain intensity and pain variation in fibromyalgia patients

Abstract Both genetic and environmental factors and gene-environment interaction have been found to contribute to the development of schizophrenia. Predisposition may manifest as prodromal vulnerability indicators before the onset of disease. The aim was to search for vulnerability signs of schizophrenia spectrum disorders, to establish the origin of these signs, and to predict the future mental disorders of adoptees with these signs. The study is a part of the Finnish Adoptive Family Study of Schizophrenia. Genetic vulnerabilty indicators were studied by comparing MMPI (Minnesota Multiphasic Personality Inventory) subscales of high-risk adoptees (HR, biological mother with a diagnosis of schizophrenia spectrum disorder) and low-risk adoptees (LR, biological mother with no diagnosed schizophrenia spectrum disorder) in the sample of all adoptees (n = 182) and in the sample of initially mentally healthy adoptees (n = 136). The later mental health status of the initially mentally healthy adoptees (assessed with DSM-III-R criteria) was predicted by MMPI subscales during the 11-year follow-up. The origins of the vulnerability indicators were investigated by assessing gene-environment interaction using parental Communication Deviance (CD) as a measure of environmental risk (n = 99). The MMPI subscales Hostility, Hypomania, and Social Maladjustment (these scales indicate emotional unresponsiveness, avolition, decreased energy, and introversion) were found to be vulnerability indicators of schizophrenia spectrum disorders. Social Maladjustment developed under gene-environment interaction when the environmental risk was assessed by CD. Psychopathic Deviate (asociality) was found to be a predictor of any later mental health disorder of the adoptees. Genetic vulnerability to schizophrenia spectrum disorders, gene-environment interaction and later onset of psychiatric disorders were found to manifest in the adoptees' MMPI. These results suggest a need to use a combination of multiple methodologies in the screening of at-risk individuals and are useful in the clinical practice of preventive mental health care. / Tiivistelmä Skitsofreniaan sairastumisessa keskeisiä ovat perintö- ja ympäristötekijät sekä näiden yhdysvaikutus. Skitsofrenia kehittyy siten, että jo ennen sairauden puhkeamista on olemassa alttiutta ilmentäviä, sairautta ennakoivia prodromaali piirteitä. Tämän tutkimuksen tarkoituksena oli etsiä skitsofreniaspektrin häiriöihin sairastumiseen liittyviä haavoittuvuutta ilmentäviä merkkejä, selvittää kuinka nämä kehittyvät ja ennustaa niillä adoptiolasten myöhempiä mielenterveydenhäiriöitä. Tutkimus on osa suomalaista adoptiolapsiperhetutkimusta. Perinnöllistä haavoittuvuuden ilmenemistä tutkittiin vertailemalla riskiadoptiolasten (biologisella äidillä oli skitsofreniaspektrin häiriö) ja heidän verrokkiensa (biologisella äidillä ei ollut skitsofreniaspektrin häiriötä) MMPI (Minnesota Multiphasic Personality Inventory) testin osa-asteikkoja kaikkien adoptiolasten ryhmässä (n = 182) ja tutkimuksen aloitusvaiheessa psyykkisesti terveiden adoptiolasten ryhmässä (n = 136). Tutkimuksen aloitusvaiheessa psyykkisesti terveiden adoptiolasten MMPI testin osa-asteikoilla ennustettiin 11 vuoden seurannassa heidän DSM-III-R kriteerein arvioitua mielenterveyttään. Perimän ja perheympäristön (adoptiovanhempien kommunikaatiohäiriöt) yhdysvaikutuksella pyrittiin selittämään haavoittuvuutta ilmentävien piirteiden syntyä (n = 99). MMPI testin osa-asteikot Hostility, Hypomania ja osittain myös Social Maladjustment (astekot ilmentävät emotionaalisen vastavuoroisuuden puutetta, tahdottomuutta, energian puutetta ja sosiaalista vetäytyneisyyttä) osoittivat perinnöllistä haavoittuvuutta skitsofreniaspektrin häiriöihin. Social Maladjustment kehittyi perinnöllisen riskin ja adoptiovanhempien poikkeavan kommunikaation yhdysvaikutuksen seurauksena. Psychopathic Deviate (asosiaalinen käyttäytyminen) ennusti adoptiolasten myöhempää sairastumista mihin tahansa mielenterveydenhäiriöön. Perinnöllinen alttius skitsofreniaspektrin häiriöihin, perintö- ja ympäristötekijöiden yhdysvaikutus sekä myöhempi sairastuminen mielenterveyden häiriöihin ilmenivät MMPI testin tuloksissa. Tuloksia voidaan käytää hyväksi mielenterveydenhäiriöiden ennaltaehkäisyssä.