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      Association between neurological soft signs, temperament and character in patients with schizophrenia and non-psychotic relatives

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          Abstract

          The heritability of schizophrenia and most personality traits has been well established, but the role of personality in susceptibility to schizophrenia remains uncertain. The aim of this study was to test for an association between personality traits and Neurological Soft Signs (NSS), a well-known biological marker of schizophrenia, in non-psychotic relatives of patients with schizophrenia. For this purpose, we evaluated the NSS scale and personality measured by the Temperament and Character inventory (TCI-R) in three groups of subjects: 29 patients with schizophrenia, 24 unaffected relatives and 37 controls. The results showed that patients with schizophrenia were more asocial (higher harm avoidance and lower reward dependence), more perseverative (higher persistence), and more schizotypal (lower self-directedness and cooperativeness, higher self-transcendence). The unaffected relatives showed higher harm avoidance, lower self-directedness and cooperativeness than the healthy controls. Higher NSS scores and sub-scores were found in patients and non-psychotic relatives compared with the controls. Among all the patients, total NSS scores were positively correlated with harm avoidance but negatively correlated with novelty seeking and persistence. Total NSS were also correlated with low scores on self-directedness and cooperativeness, which are indicators of personality disorder. Our results show that susceptibility to NSS and to schizophrenia are both related to individual differences in the temperament and character features in non-psychotic relatives of patients with schizophrenia. High harm avoidance, low persistence, low self-directedness and low cooperativeness contribute to both the risk of NSS and schizophrenia. These findings highlight the value of using both assessments to study high risk populations.

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          A brief mental health outcome scale-reliability and validity of the Global Assessment of Functioning (GAF).

          The Global Assessment of Functioning (GAF) is a quick and simple measure of overall psychological disturbance. However, there is little research on the reliability and validity of this measure in severely mentally ill populations. Multidisciplinary keyworkers assessed 103 patients at monthly intervals over a 6-month period. Overall GAF scores were obtained, with additional separate ratings for symptoms and disability. These were compared with changes in antipsychotic medication and support needs over the same period. Satisfactory reliability was obtained for total GAF score and for symptom and disability measures, in spite of raters having only one brief training session. All GAF scores were associated with current support needs of patients. Symptom and disability scores were associated with changes in antipsychotic medication in the previous month. Only symptom score was associated with increases in antipsychotic medication at time of rating. GAF proved to be a reliable and, within the limits of the indicators used, a valid measure of psychiatric disturbance in our sample of the severely mentally ill. Differences in relationships between the three GAF scores and medication/support needs indicate the usefulness of obtaining all three scores for monitoring levels and type of psychiatric disturbance in this population.
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            Psychometric properties of the positive and negative syndrome scale (PANSS) in schizophrenia.

            We analyzed the psychometric properties of the Positive and Negative Syndrome Scale (PANSS) in a sample of 100 DSM-III-R schizophrenic patients. Our findings coincided with the results of Kay's group in the following points: (1) the PANSS scores were normally distributed; (2) the positive and negative scales showed good interrater reliability; (3) positive and negative syndromes are independent constructs; (4) the positive and negative scales held a high concurrent validity in relation to the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms; and (5) although positive and negative syndromes showed factorial validity, they were not sufficient to account for the whole of the schizophrenic symptoms. Unlike Kay's group, we found a modest internal consistency of the positive scale, indicating that it is composed of several independent components. The data suggest that the distinction between positive and negative symptoms is an oversimplification, and that schizophrenic symptoms can be better conceptualized as composed of, at least three dimensional syndromes: positive, disorganized, and negative.
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              Maturity and change in personality: developmental trends of temperament and character in adulthood.

              We studied the developmental trends of temperament and character in a longitudinal population-based sample of Finnish men and women aged 20-45 years using the Temperament and Character Inventory model of personality. Personality was assessed in 1997, 2001, and 2007 (n = 2,104, 2,095, and 2,056, respectively). Mean-level changes demonstrated qualitatively distinct developmental patterns for character (self-directedness, cooperativeness, and self-transcendence) and temperament (novelty seeking, harm avoidance, reward dependence, and persistence). Character developed toward greater maturity, although self-transcendence decreased with age. However, self-transcendence was the strongest predictor of overall personality change. Cohort effects indicated lower level of self-transcendence and higher level of self-directedness and cooperativeness in younger birth cohorts. Regarding temperament, novelty seeking decreased and persistence increased slightly with age. Both high novelty seeking and high persistence predicted overall personality change. These findings suggest that temperament and character traits follow different kinds of developmental trajectories.
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                Author and article information

                Contributors
                Journal
                PeerJ
                PeerJ
                PeerJ
                PeerJ
                PeerJ
                PeerJ Inc. (San Francisco, USA )
                2167-8359
                26 April 2016
                2016
                : 4
                : e1651
                Affiliations
                [1 ]Neuropsychiatry and Addiction Institute, Parc de Salut Mar , Barcelona, Spain
                [2 ]Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM) , Barcelona, Spain
                [3 ]Departament de Psiquiatria i Medicina Legal, Universitat Autónoma de Barcelona , Cerdanyola del Vallés, Spain
                [4 ]Red de Trastornos Adictivos, RETIC , Spain
                [5 ]Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM G21 , Spain
                [6 ]Neuropharmacology, Universitat Pompeu Fabra , Barcelona, Spain
                [7 ]Department of Psychiatry and Genetics, Washington University in St. Louis , Saint Louis, MO, United States
                Article
                1651
                10.7717/peerj.1651
                4860298
                27168955
                8251901a-6457-4935-ba8c-d4b9c1945e31
                ©2016 Galindo et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.

                History
                : 17 September 2015
                : 12 January 2016
                Funding
                Funded by: Red de Transtornos Adictivos of the Instituto de Salud Carlos III
                Award ID: RD12/0028/0009
                Funded by: Centro de Investigación Biomédica en Red de Salud Mental
                Award ID: CIBERSAM G21
                Funded by: Instituto de Salud Carlos III
                Award ID: ISCIII-FIS
                Award ID: CM14/00111
                We received support from the “Red de Transtornos Adictivos” of the Instituto de Salud Carlos III (RD12/0028/0009) and the “Centro de Investigación Biomédica en Red de Salud Mental” (CIBERSAM G21). LG is a recipient of the “Río Hortega” fellowship from the Instituto de Salud Carlos III (ISCIII-FIS, CM14/00111). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Psychiatry and Psychology

                schizophrenia,neurological soft signs,temperament and character,vulnerability markers,personality

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