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      Contribución del neuroticismo, rasgos patológicos de personalidad y afrontamiento en la predicción de la evolución clínica: estudio de seguimiento a los 5 años de una muestra de pacientes con trastorno adaptativo Translated title: Contribution of neuroticism, pathological personality traits comorbidity, and coping to the prediction of clinical evolution: a five-year follow-up study of a sample of patients with adjustment disorder

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          Abstract

          RESUMEN Numerosos estudios han demostrado que tanto la personalidad como las estrategias de afrontamiento utilizadas para manejar el estrés tienen un papel importante en el desarrollo de problemas de salud mental, entre los que se encuentra el trastorno adaptativo (TA). El objetivo de este estudio fue, en primer lugar, analizar las diferencias entre neuroticismo, comorbilidad y afrontamiento en un grupo de pacientes diagnosticados de TA con evolución clínica favorable (n = 58) y otro grupo con evolución desfavorable (n = 20); en segundo lugar, se comprobó si estas variables permitían predecir la evolución clínica a los 5 años. El grupo con evolución clínica desfavorable presentó un mayor neuroticismo, más presencia de rasgos comórbidos de personalidad patológica y un afrontamiento más desadaptativo. Además, los principales factores del riesgo de pertenecer al grupo con peor evolución fueron mayor neuroticismo, presencia de comorbilidad y uso del afrontamiento de negación, mientras que las estrategias de planificación y de apoyo instrumental redujeron dicho riesgo.

          Translated abstract

          ABSTRACT Numerous studies have found that both personality and the coping strategies used to manage stress have an important role in the development of mental health problems, particularly adjustment disorder (AD). The aim of this study was, firstly, to analyze differences in neuroticism, comorbidity and coping between a group of patients with AD with a favorable clinical course (n = 58) and another with unfavorable evolution (n = 20); and secondly, to analyze whether these variables could predict clinical evolution 5 years later. The group with unfavorable clinical evolution showed a greater neuroticism, more presence of comorbid personality pathological traits, and a greater use of maladaptive coping strategies. Furthermore, the main risk factors to belong to the group with unfavorable evolution were greater neuroticism, presence of comorbidity and the use of denial coping, whereas the use of planning and instrumental support strategies lowered this risk.

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          Ten facet scales for the Big Five Inventory: Convergence with NEO PI-R facets, self-peer agreement, and discriminant validity

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            Diagnosis-specific, proven efficacious treatments are a major recent advance in psychiatry. Appropriate use of such treatments presupposes patients who meet the diagnostic criteria and clinicians who have accurately diagnosed the target disorder and comorbid conditions. Since little is known about whether these prerequisites are commonly met, the authors conducted a study at two community treatment sites to determine the frequency of various axis I diagnoses and the concordance between the diagnoses recorded in patient charts and those obtained by a structured interview. Given that a DSM diagnosis may not be sufficient to understand a patient's problems, the authors also obtained ratings of interpersonal functioning. The subjects were 164 nonpsychotic patients who were seen at a rural (N=114) or urban (N=50) community treatment facility. Raters trained to reliably use the Structured Clinical Interview for DSM-IV (SCID) conducted diagnostic interviews. Clinical charts were reviewed to obtain clinical diagnoses. Patients completed questionnaires regarding interpersonal functioning. Most (N=145, 88%) of the patients met the SCID criteria for a current axis I diagnosis, and 53% (N=87) met the criteria for two or more disorders. Clinical and SCID diagnoses had poor agreement. Evidence was found for interpersonal dysfunction. Most patients met the diagnostic criteria for conditions for which there are proven treatments; however, inaccurate diagnosis proved common. This barrier to optimal treatment could be ameliorated with the use of structured interviews for common diagnoses. Scores on social/interpersonal measures support the premise that DSM symptoms provide only part of the relevant information about patients' conditions.
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              An integrative dimensional classification of personality disorder.

              Psychological assessment research concerns how to describe psychological dysfunction in ways that are both valid and useful. Recent advances in assessment research hold the promise of facilitating significant improvements in description and diagnosis. One such contribution is in the classification of personality disorder symptomatology. The American Psychiatric Association's diagnostic manual considers personality disorders to be categorically distinct entities. However, research assessing personality disorders has consistently supported a dimensional perspective. Recognition of the many limitations of categorical models of personality disorder classification has led to the development of a variety of alternative proposals, which further research has indicated can be integrated within a common hierarchical structure. This article offers an alternative integrated dimensional model of normal and abnormal personality structure, and it illustrates how such a model could be used clinically to describe patients' normal adaptive personality traits as well as their maladaptive personality traits that could provide the basis for future assessments of personality disorder. The empirical support, feasibility, and clinical utility of the proposal are discussed. Points of ambiguity and dispute are highlighted, and suggestions for future research are provided. Copyright 2009 APA, all rights reserved.

                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                clinsa
                Clínica y Salud
                Clínica y Salud
                Colegio Oficial de Psicólogos de Madrid (Madrid, Madrid, Spain )
                1130-5274
                2174-0550
                2018
                : 29
                : 2
                : 58-62
                Affiliations
                [02] Madrid orgnameUniversidad Nacional de Educación a Distancia España
                [01] Puertollano Ciudad Real orgnameHospital Santa Bárbara orgdiv1Unidad de Salud Mental España
                Article
                S1130-52742018000200002
                10.5093/clysa2018a9
                f2727c7c-baab-40b4-9715-64374ac6c7b9

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 16 March 2018
                : 23 August 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 5
                Product

                SciELO Spain


                Coping,Adjustment disorder,Estudio longitudinal,Longitudinal study,Personalidad,Afrontamiento,Trastorno adaptativo,Personality

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