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Do self and interpersonal dysfunction cross-sectionally mediate the association between adverse childhood experiences and personality pathology? 自我和人际功能障碍是否在儿童不良经历和人格病理之间起到了交叉中介作用?
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-08-01 Epub Date: 2023-07-03 DOI: 10.1002/pmh.1588
Chloe M Evans, Leonard J Simms

Two primary limitations of research on the association between adverse childhood experiences (ACEs) and personality disorder (PD) are (1) failure to consider mechanisms of association and (2) inconsistent results due, in part, to inconsistent approaches to quantifying ACE exposure. The current study will address these limitations by examining the cross-sectional mediating role of self- and interpersonal dysfunction on the association between ACE and three PDs (antisocial, schizotypal, and borderline) using three quantifications of ACE exposure (cumulative, individual, and unique risk). Participants were 149 current or recent psychiatric patients, and data analyses were performed through estimation of a series of cross-sectional mediation models. Taken together, results suggest that (1) the association between ACE and PD is moderate, (2) self- and interpersonal dysfunction cross-sectionally mediate this association, (3) after accounting for variance shared among ACEs, associations between specific ACE subtypes and PD were negligible, (4) much of the association between ACE and PD is accounted for by general processes impacted by all forms of ACE and implicated in all forms of PD, and (5) emotional neglect may uniquely contribute to self- and interpersonal dysfunction and thereby, PD risk.

关于不良儿童经历(ACE)与人格障碍(PD)之间关系的研究的两个主要局限性是:(1)未能考虑关联机制;(2)不一致的结果,部分原因是量化ACE暴露的方法不一致。目前的研究将通过使用ACE暴露的三个量化指标(累积风险、个体风险和独特风险)来检验自我和人际功能障碍在ACE和三种PD(反社会、分裂型和临界型)之间的关联中的横断面中介作用,从而解决这些局限性。参与者是149名目前或最近的精神病患者,通过一系列横断面中介模型的估计进行数据分析。总之,结果表明:(1)ACE和PD之间的关联是中等的,(2)自我和人际功能障碍在横断面上介导了这种关联,(3)在考虑了ACE之间的共同方差后,特定ACE亚型和PD之间之间的关联可以忽略不计,(4)ACE和PD之间的大部分关联是由受所有形式的ACE影响并与所有形式的PD有关的一般过程引起的,以及(5)情绪忽视可能会独特地导致自我和人际功能障碍,从而导致PD风险。
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引用次数: 0
Adverse childhood experiences and personality functioning interact substantially in predicting depression, anxiety, and somatization. 不良的童年经历和人格功能在预测抑郁、焦虑和躯体化方面有很大的相互作用。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-08-01 Epub Date: 2023-02-05 DOI: 10.1002/pmh.1578
André Kerber, Elsa Gewehr, Johannes Zimmermann, Cedric Sachser, Jörg M Fegert, Christine Knaevelsrud, Carsten Spitzer

Etiological theories on the development of psychopathology often incorporate adverse childhood experiences (ACE) as an important contributing factor. Recent studies suggest personality functioning (PF; i.e., stability of the self and interpersonal relationships) as an important transdiagnostic construct that could be useful in better understanding when persons with ACE do (not) develop psychopathological symptoms. A representative sample of N = 2363 was assessed by questionnaires on ACE, PF (Level of Personality Functioning Scale-Brief Form 2.0), and current symptoms of depression, anxiety, and somatization (Brief Symptom Inventory 18). The interaction between ACE and PF on symptoms was investigated using multiple group models and Bayesian structural equation modeling. ACE were positively associated with psychopathology and PF impairments. The interaction effect between ACE and PF explained incremental variance in current symptoms, ranging from 26% for somatization to 49% for depression with the complete model explaining up to 91% of the latent variance in psychopathology. Our findings indicate a diathesis-stress model with PF as a resource or resilience that may buffer against the development of symptoms in the face of adversity. Treatments of depression and anxiety targeting self and interpersonal functioning therefore may lead to improvements in resilience and relapse prevention. [Correction added on 15 March 2023, after first online publication: Level of Personality Functioning Scale-Brief Form has been replaced to Level of Personality Functioning Scale-Brief Form 2.0 ].

关于精神病理学发展的病因理论通常将不良童年经历(ACE)作为一个重要的促成因素。最近的研究表明,人格功能(PF;即自我和人际关系的稳定性)是一种重要的跨诊断结构,有助于更好地了解ACE患者何时确实(没有)出现精神病理学症状。N的代表性样本 = 2363通过ACE、PF(人格功能水平量表简要表2.0)和当前抑郁、焦虑和躯体化症状(简要症状量表18)的问卷进行评估。使用多组模型和贝叶斯结构方程模型研究ACE和PF对症状的相互作用。ACE与精神病理学和PF损伤呈正相关。ACE和PF之间的交互作用解释了当前症状的增量方差,从躯体化的26%到抑郁症的49%,完整模型解释了精神病理学中高达91%的潜在方差。我们的研究结果表明,一个素质-压力模型将PF作为一种资源或弹性,可以缓冲逆境中症状的发展。因此,针对自我和人际功能的抑郁症和焦虑症治疗可能会提高恢复力和预防复发。【在首次在线发布后,于2023年3月15日添加更正:人格功能水平量表简表已替换为人格功能水平表简表2.0】。
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引用次数: 0
Examining the construct validity of the Personality Assessment Questionnaire for ICD-11 (PAQ-11) personality trait domains in a community sample. 在社区样本中检验ICD-11(PAQ-11)人格特质领域人格评估问卷的结构有效性。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-08-01 Epub Date: 2022-12-17 DOI: 10.1002/pmh.1573
Martin Sellbom, Payton M Chiasson, Tiffany A Brown, Bo Bach

The ICD-11 has a new diagnostic system for personality disorder, which includes five optional trait specifiers to characterize the diagnosed pathology. The current study evaluated the internal structure and construct validity of the Personality Assessment Questionnaire for ICD-11 (PAQ-11) personality trait domains in a US population-representative community sample. An exploratory factor analysis revealed the support for a four-factor model underlying the 17 PAQ-11 items, reflecting four of the five ICD-11 trait domains (Negative Affectivity, Detachment, Disinhibition and Anankastia). Moreover, correlation analyses revealed that the PAQ-11 domain scale scores were associated, as expected, with their counterparts from two other ICD-11 trait domain measures, as well as with traditional personality disorder scores. More broadly, the results raised questions about the structural integrity of the Dissociality domain scale, and the discriminant validity of the Disinhibition and Anankastia scales. The overall conclusion was nevertheless promising with respect to the PAQ-11 serving as a brief screening measure for the ICD-11 trait domains.

ICD-11有一个新的人格障碍诊断系统,其中包括五个可选的特征说明符来表征诊断的病理。本研究在美国人群代表性社区样本中评估了ICD-11(PAQ-11)人格特征域人格评估问卷的内部结构和结构有效性。一项探索性因素分析揭示了对17个PAQ-11项目的四因素模型的支持,该模型反映了ICD-11五个特质领域中的四个(消极情感、超然、去抑制和Anankastia)。此外,相关性分析显示,正如预期的那样,PAQ-11领域量表得分与其他两个ICD-11特征领域测量的对应值以及传统人格障碍得分相关。更广泛地说,这些结果提出了关于不社交领域量表的结构完整性,以及去抑制和Anankastia量表的判别有效性的问题。然而,关于PAQ-11作为ICD-11特征域的简短筛选措施,总体结论是有希望的。
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引用次数: 2
Connecting DSM-5 and ICD-11 trait domains with schema therapy and dialectical behavior therapy constructs. 将DSM-5和ICD-11特征域与图式治疗和辩证行为治疗结构联系起来。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-08-01 Epub Date: 2022-12-27 DOI: 10.1002/pmh.1574
Mikaela Tracy, Louise Sharpe, Bo Bach, Niko Tiliopoulos

The DSM-5 Section III alternative model of personality disorder (AMPD) and the International Classification of Diseases - 11th Edition's (ICD-11) personality disorder classification allow clinicians to identify individual trait domains in which people score highly. However, how these domains relate to constructs associated with efficacious treatment approaches is unclear. The current study aimed to determine whether constructs from two evidence-based treatments (schema therapy [ST] and dialectical behavior therapy [DBT]) were associated with maladaptive personality traits in a way consistent with underlying theories. We examined associations between ST constructs, DBT skill use and maladaptive coping styles, and personality traits in a sample of 525 adults. Bivariate intercorrelations and a series of multiple regression analyses were conducted to investigate the associations. As hypothesized, maladaptive coping was strongly associated with all trait domains. Surprisingly, poor DBT-skill use was only associated with negative affectivity, detachment, and disinhibition trait domains. Specific schema domains were associated with each personality trait domain, supporting trait domain-schema domain specificity. The current study highlights the potential clinical utility of the AMPD and ICD-11 trait models and ultimately contributes to the dearth of evidence on their likely usefulness for treatment selection, planning, and applications.

DSM-5第三节人格障碍替代模型(AMPD)和国际疾病分类-第11版(ICD-11)人格障碍分类使临床医生能够识别人们得分较高的个人特征领域。然而,这些领域如何与有效治疗方法相关的结构相关尚不清楚。目前的研究旨在确定两种循证治疗(模式疗法[ST]和辩证行为疗法[DBT])的结构是否与适应不良的人格特征相关,其方式与基础理论一致。我们在525名成年人的样本中研究了ST结构、DBT技能使用和适应不良的应对方式以及性格特征之间的关系。进行了双变量相互关联和一系列多元回归分析来研究这些关联。正如假设的那样,适应不良的应对与所有特质领域都密切相关。令人惊讶的是,DBT技能使用不佳只与消极情感、超然和去抑制特征域有关。特定的图式域与每个人格特质域相关联,支持特质域图式域的特异性。目前的研究强调了AMPD和ICD-11特征模型的潜在临床实用性,并最终导致缺乏证据表明它们可能对治疗选择、计划和应用有用。
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引用次数: 2
Associations between physical health and the alternative model of personality disorders: A cross-sectional age study. 身体健康与人格障碍替代模式之间的关系:一项横断面年龄研究。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-08-01 Epub Date: 2023-01-20 DOI: 10.1002/pmh.1576
Lisa E Stone, Daniel L Segal

The Alternative Model of Personality Disorders (AMPD) is a relatively new dimensional model of personality disorders (PDs) that assesses two diagnostic constructs: personality functioning and pathological personality traits. Thus far, research on the AMPD among older adults has been limited, but the research that does exist suggests limited generalizability to the unique biopsychosocial context of later life. To further examine the applicability of the AMPD to older adults, the purpose of this study was to examine relationships between the AMPD's two constructs with perceived physical health status among younger and older adult samples. Older adults (n = 222) and younger adults (n = 215) completed the Short Form-36 (SF-36), Levels of Personality Functioning Scale-Self-Report (LPFS-SR), and Personality Inventory for DSM-5-Brief Form (PID-5-BF). Correlations and Fisher's z-tests revealed significantly stronger relationships between the SF-36 with the LPFS-SR and PID-5-BF domains for older adults than younger adults. Additionally, age group significantly moderated the relationships between personality functioning and pathological personality traits and health. The stronger relationships between health and the AMPD's constructs for older adults suggest meaningful overlap between negative health outcomes and PD pathology. Future research should further investigate specific mechanisms in which personality pathology negatively impacts health in older adults.

人格障碍替代模型(AMPD)是一种相对较新的人格障碍维度模型,评估两种诊断结构:人格功能和病理性人格特征。到目前为止,对老年人AMPD的研究是有限的,但现有的研究表明,对晚年独特的生物心理社会背景的可推广性有限。为了进一步检验AMPD对老年人的适用性,本研究的目的是检验AMPD的两个结构与年轻人和老年人样本中感知的身体健康状况之间的关系。老年人(n = 222)和年轻人(n = 215)完成了简表-36(SF-36)、人格功能水平量表自评量表(LPFS-SR)和DSM-5简表人格量表(PID-5-BF)。相关性和Fisher z检验显示,与年轻人相比,老年人的SF-36与LPFS-SR和PID-5-BF结构域之间的关系明显更强。此外,年龄组显著调节了人格功能与病理性人格特征和健康之间的关系。老年人的健康和AMPD结构之间更强的关系表明,负面健康结果和PD病理之间有意义的重叠。未来的研究应该进一步调查人格病理学对老年人健康产生负面影响的具体机制。
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引用次数: 0
The influence of NOS1AP gene polymorphisms and childhood abuse on antisocial personality disorder in Chinese male violent inmates. NOS1AP基因多态性与童年虐待对中国男性暴力犯反社会人格障碍的影响
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-05-01 DOI: 10.1002/pmh.1572
Jinyang Li, Lichen Ouyang, Xinyao Liu, Qiuyu Wang, Zhang Min, Gang Liu, Yuan Zhong, Ning Zhang, Chun Wang, Na Liu

Antisocial personality disorder (ASPD) is a common behavioral pattern that causes sufferers to ignore or violate the rights of others. Though its cause is still unclear, previous studies have shown that childhood maltreatment is closely related to ASPD. The NOS1AP gene is associated with various neuropsychiatric diseases, but a linkage between it and ASPD has not yet been discovered. This study recruited ASPD and non-ASPD male subjects who had committed violent crimes from a prison in Nanjing, China. By comparing the two groups' genotypes, allele frequencies, and histories of childhood abuse, we explored the interaction between the NOS1AP gene and childhood maltreatment on the pathogenesis of ASPD. The results showed that polymorphism rs945713 in the NOS1AP gene was associated with ASPD and furthermore that this SNP may be involved in regulating the effect of childhood abuse on ASPD. This study found that childhood trauma increases the risk of ASPD in violent adult male inmates; for prisoners with ASPD, it is critical to pay attention to their childhood trauma and take early psychological intervention.

反社会人格障碍(ASPD)是一种常见的行为模式,导致患者忽视或侵犯他人的权利。虽然其原因尚不清楚,但先前的研究表明,儿童虐待与反社会障碍密切相关。NOS1AP基因与多种神经精神疾病有关,但它与反社会人格障碍之间的联系尚未被发现。本研究在中国南京的一所监狱中招募了有过暴力犯罪行为的反社会人格障碍和非反社会人格障碍男性受试者。通过比较两组的基因型、等位基因频率和儿童虐待史,探讨NOS1AP基因与儿童虐待在反社会人格障碍发病机制中的相互作用。结果表明,NOS1AP基因rs945713多态性与ASPD相关,且该SNP可能参与调节童年虐待对ASPD的影响。该研究发现,童年创伤增加了暴力成年男性囚犯患反社会障碍的风险;对于患有反社会人格障碍的在押人员,关注其童年创伤,及早进行心理干预至关重要。
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引用次数: 0
Mapping established psychopathology scales onto the Hierarchical Taxonomy of Psychopathology (HiTOP). 将已建立的精神病理学量表映射到精神病理学层次分类(HiTOP)上。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-05-01 DOI: 10.1002/pmh.1566
Leon P Wendt, Kristin Jankowsky, Ulrich Schroeders, Tobias Nolte, Peter Fonagy, P Read Montague, Johannes Zimmermann, Gabriel Olaru

The Hierarchical Taxonomy of Psychopathology (HiTOP) organizes phenotypes of mental disorder based on empirical covariation, offering a comprehensive organizational framework from narrow symptoms to broader patterns of psychopathology. We argue that established self-report measures of psychopathology from the pre-HiTOP era should be systematically integrated into HiTOP to foster cumulative research and further the understanding of psychopathology structure. Hence, in this study, we mapped 92 established psychopathology (sub)scales onto the current HiTOP working model using data from an extensive battery of self-report assessments that was completed by community participants and outpatients (N = 909). Content validity ratings of the item pool were used to select indicators for a bifactor-(S-1) model of the p factor and five HiTOP spectra (i.e., internalizing, thought disorder, detachment, disinhibited externalizing, and antagonistic externalizing). The content-based HiTOP scales were validated against personality disorder diagnoses as assessed by standardized interviews. We then located established scales within the taxonomy by estimating the extent to which scales reflected higher-level HiTOP dimensions. The analyses shed light on the location of established psychopathology scales in HiTOP, identifying pure markers and blends of HiTOP spectra, as well as pure markers of the p factor (i.e., scales assessing mentalizing impairment and suspiciousness/epistemic mistrust).

《精神病理学层次分类法》(HiTOP)基于经验共变对精神障碍的表型进行了组织,提供了一个从狭窄症状到更广泛的精神病理学模式的综合组织框架。我们认为,在HiTOP之前建立的精神病理学自我报告测量应该系统地整合到HiTOP中,以促进累积研究并进一步了解精神病理学结构。因此,在本研究中,我们利用社区参与者和门诊患者(N = 909)完成的大量自我报告评估数据,将92个已建立的精神病理学(亚)量表映射到当前的HiTOP工作模型上。项目池的内容效度评分用于选择p因子的双因子-(S-1)模型和五个HiTOP谱(即内化、思维障碍、脱离、去抑制外化和对抗性外化)的指标。基于内容的HiTOP量表通过标准化访谈对人格障碍诊断进行了验证。然后,我们通过估计尺度反映高级HiTOP维度的程度,在分类法中定位已建立的尺度。分析揭示了HiTOP中已建立的精神病理量表的位置,确定了HiTOP谱的纯标记和混合标记,以及p因子的纯标记(即评估精神障碍和怀疑/认知不信任的量表)。
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引用次数: 2
Late manifestation of borderline personality disorder: Characterization of an under-recognized phenomenon. 边缘型人格障碍的晚期表现:一种未被认识的现象的特征。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-05-01 DOI: 10.1002/pmh.1571
Rachel Jo, Jillian H Broadbear, Judith Hope, Sathya Rao

Although uncommon, borderline personality disorder (BPD) may manifest for the first time later in life. A retrospective clinical file audit was used to identify the clinical manifestation of BPD for the first time at or above the age of 30, and to examine whether particular clinical and psychosocial factors may be associated with a later-in-life manifestation of BPD. Twenty-three cases of late manifestation BPD were identified. People with late manifestation of BPD had similar risk factors and vulnerabilities, including childhood trauma, to the broader BPD population. They were distinguished by having higher levels of education, employment, and long-term intimate relationships. Interpersonal problems, loss of employment and reminders of past sexual trauma were key precipitating factors. The findings underscore the legitimacy of a late-manifestation diagnosis of BPD by demonstrating that BPD does not present exclusively during adolescence and early adulthood. BPD may present for the first time in later life in response to loss of protective factors or triggering of past trauma. This understanding may reduce misdiagnosis or delayed diagnosis, prescription of inappropriate treatments or delays in receiving BPD-appropriate treatments.

虽然不常见,边缘型人格障碍(BPD)可能在以后的生活中首次出现。回顾性临床档案审核用于确定30岁或以上首次出现BPD的临床表现,并检查特定的临床和社会心理因素是否可能与BPD的后期表现相关。发现23例晚期表现的BPD。晚期BPD患者与更广泛的BPD人群具有相似的风险因素和脆弱性,包括童年创伤。他们的特点是教育水平、就业水平和长期的亲密关系都较高。人际关系问题、失业和对过去性创伤的回忆是主要的诱发因素。研究结果强调了BPD晚期诊断的合法性,表明BPD并不仅仅出现在青春期和成年早期。BPD可能在晚年首次出现,是对保护因素丧失或过去创伤触发的反应。这种认识可以减少误诊或延误诊断,处方不适当的治疗或延迟接受bpd适当的治疗。
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引用次数: 0
Stalking perpetration through the lens of the alternative DSM-5 model for personality disorders. 通过另一种人格障碍的DSM-5模型的镜头跟踪犯罪。
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-05-01 DOI: 10.1002/pmh.1567
Dominick Gamache, Marie-Ève Cloutier, Jonathan Faucher, Philippe Leclerc, Claudia Savard

Emerging dimensional models of personality disorders such as the Alternative DSM-5 Model for Personality Disorders (AMPD) provide new opportunities to explore the associations between personality pathology and harmful interpersonal behaviours such as stalking perpetration. Two goals are pursued by this study: (a) To document associations between stalking, level of personality pathology, and pathological personality domains/facets; and (b) to determine the relative importance of maladaptive personality facets in the statistical prediction of stalking. Data from 1489 young adults (18-30 years old) from a community sample were analysed. Moderate positive significant correlations were found between stalking, level of personality pathology, and maladaptive personality domains. A clear gradient of severity of stalking behaviours was found across five severity degrees of personality pathology. Dominance analyses revealed that Deceitfulness was the most dominant statistical predictor in women. Unusual Beliefs and Experiences, a facet from the Psychoticism domain, made an important contribution in the prediction of stalking in men only. Impulsivity was a key predictor in both genders but more markedly in men. Results suggest that the AMPD represents a useful framework to study stalking perpetration. Identification of key personality predictors might prove relevant for identifying risk factors, underlying motives, and treatment targets for stalking perpetrators.

新兴的人格障碍维度模型,如DSM-5人格障碍替代模型(AMPD),为探索人格病理与有害人际行为(如跟踪犯罪)之间的关系提供了新的机会。本研究的两个目的是:(a)记录跟踪、人格病理水平和病态人格领域/方面之间的联系;(b)确定不适应人格因素在跟踪行为统计预测中的相对重要性。分析了来自社区样本的1489名年轻人(18-30岁)的数据。跟踪行为、人格病理水平和适应不良人格域之间存在中度显著正相关。跟踪行为的严重程度在人格病理的五个严重程度中有明显的梯度。优势分析显示,欺骗是女性最主要的统计预测因素。不寻常的信念和经历,来自精神病学领域的一个方面,在预测男性跟踪行为方面做出了重要贡献。冲动在两性中都是一个关键的预测因素,但在男性中更为明显。结果表明,AMPD是研究跟踪行为的一个有用的框架。关键人格预测因素的识别可能与识别跟踪犯罪者的风险因素、潜在动机和治疗目标有关。
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引用次数: 1
Influence of personality traits, gender, and socio-economic factors in obesity in the English Longitudinal Study of Ageing. 英国老龄化纵向研究中人格特征、性别和社会经济因素对肥胖的影响
IF 2.7 3区 医学 Q1 Nursing Pub Date : 2023-05-01 DOI: 10.1002/pmh.1575
Modou Diop, Manuel Ruiz-Adame, Alessio Gaggero

Obesity is a chronic disorder associated with high mortality rates and high morbidity. The risk of obesity is associated with certain personality traits (PTs). Some studies have found correlations among some PTs and gender. Additionally, obesity implies higher costs in daily living. The aim of this paper is to overcome this problem in the literature and estimate the association between PTs and obesity by taking into account the economic situation of the individual. This study employs data from the English Longitudinal Study of Ageing (ELSA). We focus on waves 5 and 6 of the ELSA with a sample of 6562 individuals. The results suggests that the traits of agreeableness ( β = 0.071 , se = 0.016 , p < 0.001 ) and openness ( β = 0.028 , se : 0.014 , p < 0.001 ) are positively and significantly associated with obesity. On the other hand, consciousness has a negative and statistically significant effect on obesity β = 0.072 , se : 0.017 , p < 0.001 . Results are robust to the inclusion/exclusion of different regressors.

肥胖是一种与高死亡率和高发病率相关的慢性疾病。肥胖的风险与某些人格特征(PTs)有关。一些研究发现了一些PTs与性别之间的相关性。此外,肥胖意味着日常生活成本更高。本文的目的是克服文献中的这一问题,并通过考虑个体的经济状况来估计PTs与肥胖之间的关联。本研究采用了英国老龄化纵向研究(ELSA)的数据。我们以6562个人为样本,重点研究ELSA的第5和第6波。结果表明,亲和性(β = 0.071, se = 0.016, p 0.001)和开放性(β = 0.028, se: 0.014, p 0.001)与肥胖呈显著正相关。另一方面,意识对肥胖有负的、有统计学意义的影响β = 0.072, se: 0.017, p 0.001。结果对不同回归量的纳入/排除是稳健的。
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引用次数: 0
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Personality and Mental Health
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