Personality in a Hierarchical Model of Psychopathology
Thomas A. Widiger, Martin Sellbom, Michael Chmielewski, Lee Anna Clark, Colin G. DeYoung, Roman Kotov, Robert F. Krueger, Donald R. Lynam, Joshua D. Miller, Stephanie Mullins-Sweatt, Douglas B. Samuel, Susan C. South, Jennifer L. Tackett, Katherine M. Thomas, David Watson, and Aidan G. C. Wright
Traditional classifications of psychopathology (e.g., the Diagnostic and Statistical Manual of Mental Disorders, or DSM) categorize different combinations of symptoms onto syndromes and suggest treatments for each syndrome. The Hierarchical Taxonomy of Psychopathology (HiTOP) is an alternative that considers different domains of psychopathology (e.g., internalizing, detachment) that derive from empirical research and thus organize psychopathology along these domains. Widiger et al. discuss the role of personality within the HiTOP. Different personality-trait configurations contribute differently to the development and evolution of psychopathology. Therefore, the structure of personality provides a fundamental base for the HiTOP, and personality should perhaps become the focus of preventive interventions, before the onset of psychopathology. Consistent with this idea, developing preventions and treatment protocols for domains of personality rather than (or in addition to) treating disorders and syndromes might contribute to improvements in quality of life and health.
Is Worse Attention a Risk Factor for or a Consequence of Depression, or Are Worse Attention and Depression Better Accounted for by Stress? A Prospective Test of Three Hypotheses
Naoise Mac Giollabhui, Thomas M. Olino, Johanna Nielsen, Lyn Y. Abramson, and Lauren B. Alloy
Impaired cognitive functioning (e.g., attention deficits) usually accompanies depression, but is it caused by depression, a cause for depression, or are both caused by a third process (e.g., stress)? For 3 years, Giollabhui et al. collected data from adolescents and their caregivers regarding depressive diagnosis, depressive symptoms, stressful life events, emotional maltreatment, and attention — sustained attention (i.e., focusing on one task for a long period of time), divided attention (i.e., focusing on two or more different tasks), selective attention (i.e., focusing on one task while ignoring distractions), and switching attention (i.e., switching back and forth between tasks). Giollabhui and colleagues found that the relationship between depression and attention is complex and not confined to depressive episodes. Only decreases in divided attention predicted future depressive symptoms, but switching attention declined before the first episode of depression and recovered after the episode. In fact, decreases in switching attention predicted increases in depressive symptoms, which in turn predicted worse selective and switching attention. Childhood stress, but not recent maltreatment, was associated with increases in depressive symptoms and decreases in switching attention. Overall, these results suggest the importance of considering the role of external risk factors that might increase depression and impaired cognition.
Social Anxiety and Social Behavior: A Test of Predictions From an Evolutionary Model
Erin B. Tone, Eddy Nahmias, Roger Bakeman, Trevor Kvaran, Sarah F. Brosnan, Negar Fani, and Elizabeth A. Schroth
How does social anxiety — fear and avoidance of social situations— influence social behavior in competitive contexts? Participants reported their social anxiety levels and completed a Prisoner's Dilemma game in which they selected whether they wanted to cooperate with or defect from a coplayer. The coplayer, which was always a computer, although participants were informed of it only in some of the trials, used an algorithm to decide whether to cooperate or defect. Afterward, participants reported their experiences and their goals during the game. Participants with higher social anxiety reported (a) more competitive goals than cooperative or individualistic goals and (b) greater nervousness and anger toward the coplayer during the game. Participants with higher social anxiety also tended to defect after the coplayer was cooperative. So, social anxiety predicted a tendency to respond aversively to positive behavior from others. This tendency may reflect self-protection and a lack of trust in others or an unwillingness to reciprocate positive behavior.
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Objective: Magnetic anal sphincter augmentation is a novel surgical option in the treatment of severe fecal incontinence. This study aimed to analyze functional results, quality of life, and satisfaction after implantation in the mid-term, and to identify factors associated with success of this new treatment. Methods: All patients, who underwent magnetic anal sphincter augmentation procedure at a single center between December 2008 and January 2016, were consecutively included. Symptom severity [Cleveland Clinic Incontinence Score (CCIS)], quality of life [Fecal-Incontinence Quality of Life Questionnaire (FIQL)], bowel diary data, and patients' satisfaction were assessed before and after implantation. Results: Forty-five patients (43 female), mean (s.d.) age 66.82 (±10.07), were followed for a median of 36 months (range 6–84). Two patients were explanted and 1 lost to follow-up. On a 3-week diary, major leakage rate significantly improved as did CCIS and FIQL. No significant difference was seen for flatus and minor leaks. Postoperative decrease of CCIS by ≥5.5 points correlated best with satisfaction, expressed by 22 patients (48% in intention-to-treat analysis). An independent predictive factor for success after implantation was no previous fecal incontinence surgical treatment. Conclusions: Satisfaction, functional, and quality of life outcomes improve significantly following magnetic anal sphincter augmentation.
