Gender differences in irritable bowel syndrome: the interpersonal connection.

BACKGROUND: While irritable bowel syndrome (IBS) affects women more than men, the reasons are unclear. Research on the female preponderance of IBS has focused on gender differences in sex-linked biological processes; much less attention has been paid to the role of psychosocial factors. Interpersonal difficulties may be one source of stress that may significantly impact on women with IBS. Because of the importance that women attach to relationships, we suspected they would be more reactive to interpersonal stress. METHODS: A total of 283 (M age = 41 years, F = 80%), Rome III-diagnosed IBS patients completed a test battery that included the IBS Symptom Severity Scale, McGill Pain Questionnaire, Inventory of Interpersonal Problems (IIP), interpersonal support evaluation list (social support), Negative Interactions Scale, Brief Symptom Inventory (distress), Beck Depression Inventory, Anxiety Sensitivity Inventory, and IBS-Quality of Life as part of baseline assessment of an NIH trial. KEY RESULTS: Males scored higher on two IIP scales reflecting a hostile-dominant interpersonal pattern, and reported less social support. The quality of relationship problems (more interpersonal difficulties, lower support) correlated with IBS symptom severity as measured mainly by gastroenterologists. CONCLUSIONS & INFERENCES: Male, not female, IBS patients reported more interpersonal difficulties. Male patients-a population for whom little is known-are characterized by hostile-dominant interpersonal problems. This finding has clinical importance, given that relationship problems may influence MDs' estimation of IBS symptom severity and undermine the physician-patient relationship.

Circular structure of the MCMI-III personality disorder scales.

Millon's (1987) circular model of personality disorders was examined in a large sample of psychiatric patients (N = 2,366) who completed the Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon, 1997) as part of routine assessment after presentation for treatment. Principal components analyses were conducted to identify the first two dimensions in MCMI-III base rate scores, weighted and unweighted raw scores, and nonoverlapping scale scores. Similar analyses were made on these scores when acquiescence was partialled out. Circular plots of the scales were examined against Millon's hypothesized arrangement and the model was tested using confirmatory factor analysis. Results replicated those of Strack, Lorr, and Campbell (1990) with the MCMI-II. Millon's horizontal Impassive-Expressive dimension was recovered in both regular and residual scores but the vertical axis appeared to represent an Impulsivity-Compulsivity dimension rather than the Autonomous-Enmeshed continuum envisioned by Millon. Although scale order followed Millon's predictions for the most part, a number of departures from theoretical expectations were noted and none of the score sets yielded a good fit to the hypothetical structure. Millon's model appears to have promise as a circumplex that can encompass all of the personality disorders but changes are needed to rectify discrepancies between the theory and empirical findings.

Detecting complex patterns in interpersonal profiles.

The assessment of interpersonal problems has advanced in recent years with the development of new methods for analysing individual profiles. These new methods assume that each profile can be modelled by a mathematical function that reflects the person's single prevailing interpersonal theme. However, some profiles may contain more complex patterns, with two or more distinct themes. Such complexities in a person's interpersonal profile might be clinically important, perhaps reflecting an interpersonal style that is conflictual. In an effort to detect complex patterns, Fourier analysis was applied to profiles of 200 psychotherapy out-patients and 200 undergraduates, using the Inventory of Interpersonal Problems. Although many profiles did not clearly manifest a single prevailing interpersonal theme, having two distinct profile peaks, their apparent complexity generally resulted from measurement error. Systematically complex or conflictual patterns were rarely detectable. Profiles of interpersonal problems may contain complex patterns, but simple patterns reflecting the prevailing interpersonal theme are apt to be more clinically informative.

The three faces of interpersonal dependency: structural analyses of self-report dependency measures.

Using the interpersonal circumplex and the 5-factor model of personality as a structural framework, the authors identified 3 aspects of interpersonal dependency in structural analyses of the universe of content defined by the combined item pool of widely used self-report dependency measures: love dependency, exploitable dependency, and submissive dependency. Markers of these aspects of interpersonal dependency were reconstituted, and their relations with neuroticism (N), conscientiousness (C), and openness to experience (O) were examined. All forms of interpersonal dependency are related positively with N. Exploitable and submissive dependency are increasingly negatively correlated with C and O, whereas love dependency is positively correlated with C and O. Implications regarding the assessment of dependency and multifactor models of dependency are discussed, and hypotheses for future research linking dependency and depression are proposed.