Search

Autism spectrum disorders (ASD) are difficult to detect in old age. This study examined if ASD symptoms in older adults (age > 60) can be detected with the Dutch informant personality questionnaire, (Hetero-Anamnestische Persoonlijkheidsvragenlijst, HAP) in a mental health setting. Patients with ASD (N = 40) were compared to patients with a different psychiatric diagnosis (N = 43; personality disorders excluded). The ASD group had significant higher scores on the scales 'Socially avoidant behavior', 'Rigid behavior' and 'Unpredictable and impulsive behavior'. These scales were able to discriminate between individuals with or without ASD. The HAP can thus be used as a screening instrument for ASD symptoms in elderly patients. Further research is needed to clarify what items have the best predictive validity for ASD symptoms. [ABSTRACT FROM AUTHOR]

In geriatric psychiatry, informant reports are often important due to cognitive problems and related impaired insight and judgment. Informant questionnaires to identify personality traits among older adults are sparse. The Dutch informant personality questionnaire (the HAP) is especially developed to address this need. The objective of this study is the psychometric evaluation of the HAP among older adults in the Netherlands and Belgium. We investigated the internal consistency, gender differences, the test–retest and inter-rater reliability, the factorial structure, and the concurrent validity. Informants completed the HAP ratings of nursing home residents (n = 385) and elderly psychiatric patients (n = 204). The internal consistency of the scales is good. Medium gender differences on three scales were found in the population Psychiatry. The inter-rater and test–retest reliability are good to excellent. There are significant similarities between a number of HAP scales and dimensions of the Big Five. The congruence between the factor structures in both samples is very high. We labeled the three factors externalizing/antagonistic, internalizing/neurotic, and compulsive. The HAP meets the need for validated and reliable informant instruments for personality assessment among older adults in geriatric psychiatry. The content scales of the questionnaire address traits of the premorbid personality. Therefore, the HAP might be useful for personality assessment and selecting treatment options in mental healthcare and can be applied in scientific research in the area of personality aspects in late life. [ABSTRACT FROM PUBLISHER]

Objectives: Posttraumatic stress disorder (PTSD) after exposure to multiple (childhood) trauma's is strongly associated with accelerated aging and high psychiatric and somatic comorbidity, influencing frailty and Quality of Life (QoL) in older adults. Eye Movement Desensitization therapy (EMDR) addresses psychological and physiologic symptoms stemming from adverse life events and therefore could influence frailty and QoL in older adults., Methods: We conducted a multi-center feasibility study (two psychiatric hospitals) in Dutch older outpatients (N = 24; ≥60 years) with PTSD. Participants received weekly EMDR-treatment during the course of the trial (3 months to a maximum of 9 months). Frailty (Groninger Frailty Indicator) and QoL (EuroQol 5D-3L), were assessed pre- and posttreatment., Results: A linear mixed-model approach showed significant reduction of frailty (F(1,23) = 9.019, p = .006) and improvement of QoL (F(1,23) = 13.787, p = .001). For both frailty and QoL, there was no significant influence of Clinician-Administered PTSD Scale (CAPS-5) pre-treatment score, therapy duration, and neither an interaction effect of therapy duration x CAPS-5 pre-treatment score., Conclusions: EMDR with older adults with PTSD showed a significant reduction of frailty and improvement of QoL. Randomized controlled studies are needed to more precisely study the impact of trauma-focused treatment in older adults on frailty and QoL and the implications this might have for lessening disease burden., Clinical Implications: Screening for PTSD in older frail adults is important to treat PTSD as a possible way to reduce frailty and improve QoL.

Previous research on self-informant reports in assessing personality disorders (PDs) has been mainly focused on adults, leaving older adults under-studied. We examined self-informant agreement in PD screening among older adults (≥60 years) using the Gerontological Personality disorders Scale (GPS). Potential differences such as who reports more personality pathology on a PD screener (i.e., GPS), item accessibility and the effect of relational aspects were studied as well. Data of 326 older adult-informant dyads, of which the older adults were sampled from five general practices in the Netherlands, were used. Results indicate that self-informant agreement ranged from r = 0.26-0.73, with lower concordance on the GPS-subscale measuring intrapersonal aspects of personality pathology. Informants were more sensitive to habitual pathological personality features than older adults. Two GPS items showed differential item functioning across self- and informant-report. Of relational aspects, only congeniality affected the GPS-iv scores; lower ratings on congeniality were associated with higher GPS-iv scores (i.e., higher reporting of personality problems)., (© 2023 John Wiley & Sons Ltd.)

Background: The Dutch Personality Inventory for DSM-5 (PID-5-NL) is the APA recommended questionnaire to assess maladaptive personality traits as defined in the Alternative DSM-5 model of personality disorders., Aim: To describe of the psychometric qualities of the PID-5-NL, present of normative data and apply the PID-5-NL in clinical practice., Method: The PID-5-NL was administered in a sample of adults from the general population in Flanders (Belgium) and in a sample of patients with a personality disorder in mental health care in the Netherlands. Scores on the PID-5 of a patient with borderline personality disorder are illustrated in a case vignette., Results: Reliability and validity of the PID-5-NL were satisfactory to good, and comparable with results from international research on the PID-5. It was remarkable that in the current research group, patients scored as low as or even lower than the group from the general population on a number of trait facets., Conclusion: The PID-5-NL questionnaire is a useful tool to gain insight in a straightforward way into a wide range of relevant personality traits for diagnosis and treatment planning; provisional reference groups for the clinical practice in regular mental health care are made available on the basis of this study. Further refinement of the reference groups and further research within patients with externalizing personality problems is recommended.

This study brings more clarity on the inconsistent findings on emotional reactivity differences between older (OA) and younger (YA) adults, by examining the influence of (mal)adaptive personality traits on emotional reactivity and by applying several assessment methods. We recruited 60 YA (25-50 years) and 60 OA (65+ years) from a nonclinical population. We used Visual Analogue Scales to measure subjective reactivity, and facial electromyography (corrugator and zygomaticus reactivity), heart rate, heart rate variability, and skin conductance level to assess physiological reactivity during happy and sad film clips. Results showed that personality influences on emotional reactivity in OA were largely comparable to YA, although the influence of negative emotionality and neuroticism on subjective reactivity in response to the sad film was significantly stronger in OA. It is thus important to assess both subjective and physiological reactivity when comparing age-related differences in OA and YA given the differential relation with personality features.

The alternative model for personality disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5) is considered an important step toward a possibly better conceptualization of personality pathology in older adulthood, by the introduction of levels of personality functioning (Criterion A) and trait dimensions (Criterion B). Our main aim was to examine age-neutrality of the Short Form of the Severity Indices of Personality Problems (SIPP-SF; Criterion A) and Personality Inventory for DSM-5-Brief Form (PID-5-BF; Criterion B). Differential item functioning (DIF) analyses and more specifically the impact on scale level through differential test functioning (DTF) analyses made clear that the SIPP-SF was more age-neutral (6% DIF, only one of four domains showed DTF) than the PID-5-BF (25% DIF, all four tested domains had DTF) in a community sample of older and younger adults. Age differences in convergent validity also point in the direction of differences in underlying constructs. Concurrent and criterion validity in geriatric psychiatry inpatients suggest that both the SIPP-SF scales measuring levels of personality functioning (especially self-functioning) and the PID-5-BF might be useful screening measures in older adults despite age-neutrality not being confirmed.

We examined the factorial structure of the Dutch version of the Personality Adjective Checklist (PACL-D) in a Belgian sample of 3,012 community-dwelling adults. Exploratory factor analyses revealed a 5-factor structure (Neurotic, Aggressive/Dominant, Introverted vs. Extraverted, Conscientious, and Cooperative), that showed considerable overlap with 3 of the Big Five factors (i.e., Neuroticism, Extraversion, and Conscientiousness). Moreover, the 5-factor structure closely resembled the structure found in the original American PACL and was equivalent across gender and age.

Earlier factor analytical studies on the empirical validity of the DSM-IV-TR (American Psychological Association, 2000) Axis II classification have offered little support for the current three-cluster structure. In his large-scale meta-analysis of previously published personality disorder correlation matrices, O'Connor (2005) found four factors, corresponding to the neuroticism, extraversion, agreeableness, and conscientiousness domains of the five-factor model of personality. In the present study, this dimensional four-factor model and the categorical DSM three-cluster structure were fitted to the Assessment of DSM-IV Personality Disorders questionnaire (ADP-IV; Schotte & De Doncker, 1994) scale scores using structural equation modelling. The results strongly favored the dimensional model, which also resembled other well-founded four-factor proposals (Livesley, Jang, & Vernon, 1998; Widiger & Simonsen, 2005). Moreover, a multigroup confirmatory factor analysis showed that this model was highly invariant and thus generalizable across two large clinical (n = 1,029) and general population (n = 659) samples.

We analyzed the factor structure of the Dutch-language version of the MCMI-III (Millon, Millon, Davis, & Grossman, 2006) using exploratory factor analysis on data obtained from a heterogeneous White sample (n = 1,210). We identified 4 factors: General Maladjustment, Aggression/Social Deviance, Paranoid/Delusional Thinking, and Emotional Instability/Detachment. This structure was invariant across scale composition (linear dependent vs. independent scales), factor analytic method (principal factor vs. principal component solutions), and sample characteristics (gender 'male-female' and setting 'clinical-forensic.' Studies that have used previous MCMI (Millon, 1969/1983b) versions have also found 4 similar factors, whereas studies that have used the American version of the MCMI-III have only found 3 factors. However, differences between the Dutch and American version were completely determined by factor analytic decisions. The factor structure of the MCMI-III appeared to be cross-culturally invariant.