A meta-analysis of the association between the serotonin transporter gene polymorphism (5-HTTLPR) and trait anxiety.

Studies of the association between polymorphisms of the serotonin transporter gene (5-HTT) and trait anxiety have produced inconsistent results, raising questions about the strength of the relationship and the methodological conditions under which the relationship holds. We conducted a meta-analysis of existing studies to provide formal statistical measures of the strength of the linked polymorphic region of the serotonin transporter gene (5-HTTLPR)-anxiety relationship. For the entire collection of 26 studies, results provided no support for a relationship between anxiety and the presence of the short form of the 5-HTTLPR polymorphism. There was strong evidence of the presence of moderating variables, however, and subsequent analysis revealed that choice of the measure of trait anxiety was significant. Studies using the Neuroticism scale of Costa and McCrae were found to produce a small positive effect (d=0.23). Other potential moderators (country of study origin, type of subject) did not have a meaningful impact on d statistics. These findings indicate that 5-HTTLPR may in fact have a small but reliable influence on personality, particularly in the manifestation of trait anxiety when measured with a neuroticism scale based on the five-factor model of personality. Our results suggest that the success of future personality genetics research will be maximized by the use of personality measures from both the psychobiological and five-factor models.

DRD4 and novelty seeking: results of meta-analyses.

Studies of the association between polymorphisms within and near the dopamine D4 receptor (DRD4) gene and novelty seeking (NS) have produced inconsistent results, raising questions about the strength of the relationship and the methodological conditions under which the relationship holds. We conducted three meta-analyses of existing studies to provide formal statistical measures of the strength of the DRD4-NS relationship. Results provided no support for a relationship between NS and the presence of the 7-repeat allele of the VNTR polymorphism. A small positive effect, however, was found for long repeats of the same polymorphism. The most promising findings were obtained for the relationship with the -521 C/T promoter polymorphism, for which the analysis showed an effect size of 0.32. The positive findings are consistent with a polygenic model of influence on fundamental personality dimensions.

A functional polymorphism within the mu-opioid receptor gene and risk for abuse of alcohol and other substances.

Genetic association studies investigating the role of the +118A allele of the human mu-opioid receptor gene in risk for alcohol dependency have produced inconsistent findings, possibly because of the failure to recognize sampling methodology difficulties inherent in association studies of polygenic disorders. We examined the frequency of the AA genotype and A allele in several groups of substance-dependent cases, unrestricted controls, and super controls screened for the use of alcohol and cigarettes. Our findings and analyses suggest that the OPRM1 +118 polymorphism is a general risk gene for substance dependence, but is not specific to a particular substance. The nature of the conferred risk is likely to be in use of multiple substances, but it is not yet determined if the risk could be expressed in severity of use of any particular substance. The contribution of the gene to risk for substance dependence is small, and is detected most easily in studies that use control samples that are screened for all forms of substance dependence.

Research Validity Scales for the NEO-PI-R: additional evidence for reliability and validity.

We examined the reliability and validity of the research validity scales (Schinka, Kinder, & Kremer, 1997) for the NEO-Personality Inventory-Revised (NEO-PI-R) in a clinical sample. The Negative Presentation Management (NPM) and Positive Presentation Management (PPM) scales were found to have satisfactory internal consistency reliability. Support for the validity of these scales was provided by the pattern of convergent and discriminant correlations with respective Personality Assessment Inventory (PAI) validity scales. Finally, PAI profiles of individuals with invalid NPM scores were found to differ significantly from those with valid NPM scores. Comparisons of the invalid profiles with profiles from other clinical samples provided additional support for the use of the NPM scale as a measure of negative impression management.

Differential episodic and semantic memory performance in Alzheimer's disease and vascular dementias.

Differential performance on measures of episodic and semantic memory were examined in AD, cortical vascular dementia (CVaD), subcortica] vascular dementia (SVaD), and controls. Groups were matched on age, education, and gender; dementia groups also were matched on severity. Recognition/retrieval differences were found only between SVaD and AD groups, not between CVaD and AD. Thus, recognition/retrieval differences are likely secondary to subcortical pathology rather than to vascular etiology per se. Similarly, significant numbers of memory errors were associated with cortical pathology, regardless of etiology. Error rate differences were found only between SVaD and AD groups, not between CVaD and AD. Finally, rapid forgetting was unique to AD; however, since no difference was found between SVaD and AD, rapid forgetting may occur only as AD progresses. No semantic memory measure differentiated AD from either CVaD or SVaD subjects. Results suggest that some previously reported episodic differences may be due to cortical versus white matter subcortical pathology, rather than to AD versus vascular etiology.

Material-specific memory in traumatic brain injury: differential effects during acquisition, recall, and retention.

Material-specific memory refers to the ability to learn and recall new episodic information on the basis of the nature of the stimulus material (e.g., verbal vs. nonverbal-visuospatial). Structural equation modeling was used to analyze data from a sample of patients with traumatic brain injury to compare 3 models of memory functioning: material-specific, material-specific plus general, and general (non-material-specific). The models were examined separately for acquisition, delayed free recall, and retention aspects of memory. Results suggest that, at least in a population with traumatic brain injury, the acquisition of new information takes place in a material-specific memory fashion, delayed free recall involves both material-specific and general (non-material-specific) memory components, but retention relies primarily on general (non-material-specific) memory processes.

Association between Alzheimer's disease and a functional polymorphism in the Myeloperoxidase gene.

A polymorphism in the Myeloperoxidase gene (MPO) has previously been demonstrated to be associated with gender-specific risk in an Alzheimer's Disease (AD) autopsy sample. We have investigated this polymorphism in our own samples of 226 Caucasian cases and 166 controls and 59 Hispanic cases and 75 controls. In Caucasians we find a significant association between MPO genotype and AD (P = 0.03), although we do not observe any effects of gender or any interaction with the APOE gene. Specifically, the MPO GG genotype contributes a 1.57-fold increased risk for AD. In Hispanics there was no effect of MPO genotype, or of MPO genotype in interaction with age or gender, on diagnosis of AD.

A polymorphism in the cystatin C gene is a novel risk factor for late-onset Alzheimer's disease.

OBJECTIVE: To investigate whether or not a coding polymorphism in the cystatin C gene (CST3) contributes risk for AD. DESIGN: A case-control genetic association study of a Caucasian dataset of 309 clinic- and community-based cases and 134 community-based controls. RESULTS: The authors find a signficant interaction between the GG genotype of CST3 and age/age of onset on risk for AD, such that in the over-80 age group the GG genotype contributes two-fold increased risk for the disease. The authors also see a trend toward interaction between APOE epsilon4-carrying genotype and age/age of onset in this dataset, but in the case of APOE the risk decreases with age. Analysis of only the community-based cases versus controls reveals a significant three-way interaction between APOE, CST3 and age/age of onset. CONCLUSION: The reduced or absent risk for AD conferred by APOE in older populations has been well reported in the literature, prompting the suggestion that additional genetic risk factors confer risk for later-onset AD. In the author's dataset the opposite effects of APOE and CST3 genotype on risk for AD with increasing age suggest that CST3 is one of the risk factors for later-onset AD. Although the functional significance of this coding polymorphism has not yet been reported, several hypotheses can be proposed as to how variation in an amyloidogenic cysteine protease inhibitor may have pathologic consequences for AD.

A taxometric analysis of MMPI-2 Infrequency scales [F and F(p)] in clinical settings.

The typology of overreporting, which is a deliberate attempt to amplify symptoms, simulate psychopathology, or understate coping capacities, was examined using taxometric procedures with Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Infrequency scales [F and F(p)] in psychiatric inpatient and Veterans Affairs (VA) medical center treatment settings. Overreporting was identified as a taxon using several taxometric procedures, and the multiple estimates of the taxon base rate were consistent within each sample. Mean base-rate estimates were .27 and .19 for the psychiatric inpatient and VA medical center settings, respectively. Overall classification rates ranged from .80 to .97 across the 2 settings, which supports the use of F and F(p) in the identification of overreporting on the MMPI-2 in psychiatric inpatient and VA medical center settings.

Elderly norms for the Hopkins Verbal Learning Test-Revised.

The present study evaluates the effects of age, education, and gender in a representative sample of older adults and provides normative data for community-dwelling elderly. Age and gender had significant effects on HVLT-R performance. We provide age- and gender-adjusted normative data. Surprisingly, education level did not affect HVLT-R performance, indicating that education-adjusted norms are not necessary for this measure within this age range. We evaluated a subsample of subjects census-matched on age, education, and gender. These subjects did not differ in overall performance from our entire sample. Therefore, the normative data provided in this paper can be considered to be census-comparable for age, education, and gender.

Changes in personality characteristics in women treated in a therapeutic community.

We examined changes in mood and personality characteristics in a sample of cocaine-dependent women being treated in a therapeutic community (TC). Forty-six women completed the Beck Depression Inventory (BDI), the Hamilton Anxiety Scale (HAM-A), and the Millon Clinical Multiaxial Inventory-II (MCMI-II) on admission and 12 months after discharge from the TC. On admission, the group was characterized by clinically significant scores on the BDI, HAM-A, and the MCMI-II Avoidant, Dependent, Antisocial, Passive-aggressive, Self-defeating, and Borderline scales. On follow-up, significant improvement in functioning was suggested by decreases in scale scores on the BDI, HAM-A, and MCMI-II Avoidant, Dependent, Self-Defeating, and Borderline Scales, but not for the MCMI-II Antisocial and Passive-Aggressive scales. These results suggest substantial positive effects of TC treatment on personality characteristics and functioning, but also indicate that TC treatment may not habilitate all critical personality deficits.

Comparing methods for estimating premorbid intellectual functioning.

Efforts to determine premorbid intellectual functioning for a patient prior to their current evaluation has been attempted using demographic information, current performance data, or a combination of both. Five of these premorbid intellectual prediction methods were assessed in a sample of 104 neurological patients referred for neuropsychological evaluation and a matched control sample. Predicted Full-Scale Intelligence Quotient (FSIQ) scores of patients did not differ from the true FSIQ scores of the matched controls. Logistic regression analyses found no difference in classification accuracy among the prediction methods. The findings of this study found combined demographic and performance methods developed by Vanderploeg and Schinka (1995), Vanderploeg, Schinka, and Axelrod (1996), Krull, Scott, and Sherer (1995) and Williamson, Krull, and Scott (1996) to be accurate estimates of premorbid functioning. This study found estimates of premorbid functioning based on demographic data alone (Barona, Reynolds, & Chastain, 1984) not to differ from the other methods, which is at odds with prior studies. Prospective studies employing all of these methods are recommended to clarify the utility of demographically based estimates.

Effects of psychopathology and demographic characteristics on MMPI-2 scale scores.

Using multiple linear regression analyses, we examined the effects of subject status for 6 demographic variables and the presence of psychopathology on variance in MMPI-2 scale scores. The analyses were designed to measure the incremental contribution of the demographic variables to scale variance beyond that explained by presence of psychopathology. Demographic variables were found to contribute little incremental variance for the validity and clinical scales, but did explain more than 10% of the score variance for 1 clinical scale, 2 content scales, and 5 supplemental scales. For these 8 scales, gender was most often the potent demographic variable and an expected influence. The results are discussed in light of the use of gender-based norms and in terms of other potential factors that might explain MMPI-2 scale score variance.

Comparative outcomes and costs of inpatient care and supportive housing for substance-dependent veterans.

OBJECTIVE: This study examined the differential effectiveness and costs of three weeks of treatment for patients with moderately severe substance dependence assigned to inpatient treatment or to a supportive housing setting. Supportive housing is temporary housing that allows a patient to participate in an intensive hospital-based treatment program. Type and intensity of treatment were generally equivalent for the two groups. METHODS: Patients were consecutive voluntary admissions to the substance abuse treatment program of a large metropolitan Veterans Affairs medical center. Patients with serious medical conditions or highly unstable psychiatric disorders were excluded. Patients in supportive housing attended the inpatient program on weekdays from 7:30 a.m. to 5 p.m. They were assessed at baseline and at two-month follow-up. RESULTS: Baseline analyses of clinical, personality, and demographic characteristics revealed no substantive differences between the 62 patients assigned to inpatient treatment and the 36 assigned to supportive housing. The degree of treatment involvement and dropout rates did not differ between groups. Of the 55 inpatients completing treatment, 29 were known to be abstinent at follow-up, and of the 35 supportive housing patients completing treatment, 22 were abstinent. The proportion was similar for both groups, about 70 percent. The cost of a successful treatment for the inpatient group was $9,524. For the supportive housing group, it was $4,291. CONCLUSIONS: Given the absence of differential treatment effects between inpatient and supportive housing settings, the use of supportive housing alternatives appears to provide an opportunity for substantial cost savings for VA patients with substance dependence disorders.

An investigation of malingering posttraumatic stress disorder on the Personality Assessment Inventory.

Utilizing the Personality Assessment Inventory (PAI; Morey, 1991), this study aimed to isolate a pattern of responding that is indicative of an attempt to malinger posttraumatic stress disorder (PTSD). The PAI profiles of 116 male participants were examined. Profiles of a group of 29 alcohol-abusing veterans with a primary Axis I (American Psychiatric Association, 1994) diagnosis of PTSD and a group of 30 alcohol-abusing veterans with no other diagnoses were compared to those of 27 undergraduate men instructed to feign PTSD. Control data were obtained from another group of 30 undergraduates. The student malingerers produced PAI profiles that were significantly different from the veterans with PTSD. Seven scales distinguished the malingerers from the veterans with an actual diagnosis of PTSD. Malingerers tended to overexaggerate pathology, inflating their scores on many clinical scales greater than the mean of the PTSD sample. Malingerers also scored higher on Morey's (1993) 8-item Malingering Index than either group of veterans and the controls. Only 2 scales reliably differentiated alcohol-abusing veterans with PTSD from those without the disorder. The implications of these findings in the diagnosis of PTSD are discussed.

Correspondence between five-factor and RIASEC models of personality.

In this study, we examined relationships between the full five-factor (FF; Costa & McCrae, 1985, 1992; Digman, 1990) and Holland's (1985a) RIASEC models of personality in a sample of 1,034 adults. The NEO Personality Inventory-Revised (Costa & McCrae, 1992) and the Self-Directed Search (Holland, 1985c) provided measures of the FF and RIASEC dimensions, respectively. Canonical correlation analyses provided evidence primarily for a pattern of linkages between the FF Extraversion, Openness, and Agreeableness measures and the RIASEC Enterprising, Artistic, and Social scales. Findings from this and previous studies indicated that the FF model appears to ignore the Realistic dimension and provides coverage of the Investigative and Conventional dimensions in women only. In turn, the RIASEC model appears to provide modest coverage of the FF Neuroticism and Conscientiousness domains for women and not at all for men.

Profile clusters in the WAIS-R standardization sample.

In this study we applied clustering procedures to a subgroup of 341 participants from the WAIS-R standardization sample. These individuals were selected by virtue of their having full-scale profiles characterized by scatter of greater than 8 scaled scores. Using a hierarchical clustering algorithm, a multistage procedure was used to establish and evaluate a cluster solution. The subject selection and clustering methods were successful in revealing a set of 9 profile types characterized by unique profile shapes. All profiles were associated with FSIQs that were at least in the average range. Seven of the profiles were characterized by specific subtest strengths, only 1 with subtest weaknesses. Examination of the external correlates of profile membership revealed differences among profile groups for age, marital status, education, and occupation. Our findings suggest that variability in and across the 9 profile types in this sample reflects increased contributions of unique abilities in comparison to the influence of the underlying primary and secondary WAIS-R dimensions of cognitive ability.

Odd-even short forms of the Judgment of Line Orientation Test.

The Judgment of Line Orientation (JLO) Test is a relatively pure measure of visuospatial perception, analysis, and judgment. Among those with brain injury, the JLO is sensitive to right-hemisphere insult, particularly insult to the posterior right hemisphere. Individuals presenting other cognitive deficits, however, such as attentional dysfunction or problems with sustained effort may have difficulty completing the full 30-item JLO test. In an effort to minimize these factors, as well as maximize the probability of obtaining an interpretable protocol, the efficacy of 15-item versions of the JLO was explored. The results of this investigation suggest that utilizing the doubled raw score from odd or even 15-item short forms is a viable alternative to administering the full30-item version of the JLO.