Maladaptive Personality Traits and 10-Year Course of Psychiatric and Medical Symptoms and Functional Impairment Following Trauma

Abstract

Background Personality is a major predictor of many mental and physical disorders, but its contributions to illness course are understudied. Purpose The current study aimed to explore whether personality is associated with a course of psychiatric and medical illness over 10 years following trauma. Methods World Trade Center (WTC) responders (N = 532) completed the personality inventory for DSM-5, which measures both broad domains and narrow facets. Responders' mental and physical health was assessed in the decade following the WTC disaster during annual monitoring visits at a WTC Health Program clinic. Multilevel modeling was used in an exploratory manner to chart the course of health and functioning, and examine associations of maladaptive personality domains and facets with intercepts (initial illness) and slopes (course) of illness trajectories.Results Three maladaptive personality domains-negative affectivity, detachment and psychoticism-were uniquely associated with initial posttraumatic stress disorder (PTSD); detachment and psychoticism were also associated with initial functional impairment. Five facets-emotional lability, anhedonia, callousness, distractibility and perceptual dysregulation-were uniquely associated with initial mental and physical health and functional impairment. Anxiousness and depressivity facets were associated with worse initial levels of psychiatric outcomes only. With regard to illness trajectory, callousness and perceptual dysregulation were associated with the increase in PTSD symptoms. Anxiousness was associated with greater persistence of respiratory symptoms. Conclusions Several personality domains and facets were associated with initial levels and long-term course of illness and functional impairment in a traumatized population. Results inform the role of maladaptive personality in the development and maintenance of chronic mental-physical comorbidity. Personality might constitute a transdiagnostic prognostic and treatment target.

Artificial Intelligence Language Predictors of Two-Year Trauma-Related Outcomes

“…Anxiety and hostility are also established predictors of PTSD symptoms (DiGangi et al, 2013;Olatunji et al, 2010), and in the present study, we found significant moderate effects for both. ALP neuroticism predicted LRS, replicating a link between LRS and self-reported neuroticism observed in another sample of WTC responders (Waszczuk et al, 2018). Suicidality was predicted by depressivity and stress ALPs, which also replicates prior associations (Liu et al, 2006;R.…”

“…Despite 20 years passed since September 11 th , 2001, responders continue to show high rates of both psychiatric and medical sequelae of trauma (Bromet et al, 2016;Wisnivesky et al, 2011). Most participants in the present sample suffer from chronic symptoms and two years is not sufficient length of time to observe substantial change (Waszczuk et al, 2018). Hence, we did not seek to predict change, but thought it important to measure outcomes at a different time point from predictors to avoid transient methodological confounds (e.g., state effects, response biases) and allow for a clear temporal sequence between predictors and outcomes.…”

Anxiety, Depression and Posttraumatic Stress Disorder after Terrorist Attacks: A General Review of the Literature

“…One study found that a genetic polymorphism of the serotonin transporter (5-HTT (5-hydroxy tryptamine)] gene) may have led to higher rates of PTSD post 9/11 [45]. Personality characteristics associated with PTSD include negative affectivity, detachment and psychoticism, as well as less perceived self-efficacy [51,54]. In first responders, having only basic life-saving training versus more intermediate or advanced training, was found to be a risk factor for PTSD [31].…”

“…In regard to symptomatology and comorbidities, risk factors for more severe PTSD include having severe hyperarousal symptoms, experiencing bereavement, being injured by the attack, having a history of PTSD, depression or anxiety pre-attack, having other medical conditions diagnosed post-attack, higher levels of exposure to the attack and a lifetime trauma burden, especially post attack [27,42,60]. Finally, from a temperament perspective, using coping strategies such as substance use and avoidance, as well as callousness and perceptual dysregulation personality traits, can worsen the trajectory of the illness [51,60].…”

Differential Effects of Psychological Interventions in Online and Face-to-Face Settings on DSM-5 and ICD-11 Maladaptive Trait Domains: An Exploratory Pilot Study

“…This research not only endorses the reliability and utility of dimensional assessments of personality disorders but increasingly indicates that maladaptive personality patterns may constitute an important transdiagnostic factor for general psychopathology. Research showed moderate to strong associations of maladaptive personality patterns with a range of other mental disorders, e.g., anxiety and depression ( 6 ), internalizing and externalizing disorders ( 7 ), psychotic disorders ( 8 ), substance-related disorders ( 9 ), and posttraumatic stress disorder ( 10 ). They have also been shown to be related to transdiagnostic variables, such as interpersonal problems ( 11 ), childhood maltreatment ( 12 ), maladaptive schemas ( 13 ), pathological beliefs ( 14 ), emotion dysregulation ( 15 ) or attachment anxiety and avoidance ( 16 ).…”