Elisabet Sundbom

Personality traits and disorders among transsexuals.

A group of transsexuals, 9 biological men and 10 women, was assessed according to clinical DSM‐III‐R diagnosis and a self‐report instrument for Axis II diagnoses based on the Structured Clinical Interview for DSM‐III‐R (SCID screen). A control group of 133 individuals was assessed by the same instrument. Combined with a functional criterion according to the Global Assessment of Functioning, the SCID screen showed good agreement with clinical Axis II diagnoses. The overall proportion of Axis II criteria fulfilled, proportion of criteria fulfilled for every single personality disorder and number of personality disorders were calculated from the modified version of the SCID screen. Personality disorders, mainly within cluster B, were identified among 5 of 19 transsexuals, and a majority had multiple personality disorders. Among controls, no personality disorder was identified. Personality traits as measured by the SCID screen revealed significantly more subthreshold pathology among transsexuals than controls in 8 of 12 personality categories. The proportion of overall Axis II criteria fulfilled was 29% among transsexuals versus 17% among controls. Sex differences among transsexuals, the usefulness of the SCID screen and diagnostic problems in DSM‐III‐R with respect to gender identity disorders are discussed.

PLS model building: a multivariate approach to personality test data.

The aim of this study was to demonstrate how personality test data can be plotted with a multivariate method known as Partial Least Squares of Latent Structures (PLS). The basic methodology behind PLS modeling is presented and the example demonstrates how a PLS model of personality test data can be used for diagnostic prediction. Principles for validating the models are also presented. The conclusion is that PLS modeling appears to be a powerful method for extracting clinically relevant information from complex personality test data matrixes. It could be used as a complement to more hard modeling methods in the process of examining a new area of interest.

The relationship between post-traumatic symptoms and life in exile in a clinical group of refugees from the former Yugoslavia

Objective: To investigate the association between life situation factors and post‐traumatic symptoms among refugees from the former Yugoslavia.

Is Disturbed Sleep a Mediator in the Association between Social Support and Myocardial Infarction

The objective of this study was to investigate a mediating relationship between social support and disturbed sleep in cases surviving myocardial infarction. The case-referent studies, Stockholm Heart Epidemiological Program (SHEEP) and Västernorrland Heart Epidemiological Program (VHEEP) were used comprising 6231 participants (2046 women). Referents were randomly selected. Disturbed sleep was operationalized by the Karolinska Sleep Questionnaire, network support by the Availability of Social Integration Index and emotional support by the Availability of Attachment Index. Mediating associations were tested with logistic regression. The results show that disturbed sleep may act as a mediator between low network support and myocardial infarction in women.

Assessment of self-conscious emotions : A Swedish psychometric and structure evaluation of the Test of Self-Conscious Affect (TOSCA)

The Test of Self-Conscious Affect (TOSCA) is a well-established scenario-based questionnaire assessing self-conscious emotions, such as shame and guilt, which have been shown to be differentially associated with a variety of functional, motivational, behavioral and health outcomes. The aim of this study was to evaluate the psychometric properties and internal structure of a Swedish version of TOSCA in a sample of 361 healthy adults. The psychometric properties and internal consistency of the Swedish version were at level with the original US TOSCA version for shame, guilt and detachment. The internal structure of the Swedish version was acceptable for shame, guilt and detachment but contained shortcomings in assessment of externalization.

Multivariate modelling and the Defence Mechanism Test: a comparative study of defensive structures in borderline, other personality disorders and schizophrenic disorder

The study aims at discerning discriminating patterns in the perceptual responses according to the projective percept‐genetic method Defence Mechanism Test (DMT) among 45 subjects with the diagnoses borderline personality disorder (BPD), other personality disorders (OPD), schizophrenic disorder (SD) and a non‐patient group. The overall results show that, by means of partial least squares (PLS) discriminant analysis of 130 DMT variables. it is possible to separate these groups. Patients with a BPD or a SD diagnosis and the non‐patient group are clearly separated, whereas the OPD group shows a less homogeneous pattern. The findings support both the validity of the DMT as a method to measure personality features and the psychodynamic validity of BPD. The most characteristic properties of the BPD group are responses of emotional expressions, especially introaggression and frequent distortions of the stimulus picture. Regarding the SD OPD group, a pattern of high threshold values for perception emerges as a discriminating feature as well as different variants of introjection. The non‐patients are characterized by very few DMT distortions and consequently show a good reality orientation. The conclusion is that the DMT and the PLS discriminant analysis are powerful methods in the assessment of personality pathology.

Defensive characteristics in individuals with amalgam illness as measured by the percept-genetic method Defense Mechanism Test.

Twenty patients complaining of symptoms deriving from their amalgam fillings and a non-patient group were assessed by means of the perceptual projective Defense Mechanism Test (DMT). The test protocols were scored for 130 DMT variables and analyzed by means of the multivariate statistical method Partial Least Squares discriminant analysis. The objective was to try to distinguish the group with amalgam illness from the non-patient group by means of the DMT. The results showed that it was possible to distinguish the two groups significantly from each other. The most characteristic traits of the patient group were a general lateness in perception and few emotional responses compared with the non-patient group and, especially, an inability to perceive the aggressive component in the stimulus picture. The DMT seems to be a powerful method in the effort to understand the mechanisms underlying the problems of amalgam illness.

Object relation and defensive operations in transsexuals and borderline patients as measured by the Defense Mechanism Test

The aim of the present study was to discern discriminating patterns in the perceptual responses in accordance with the Defense Mechanism Test (DMT), a projective perceptgenetic method, among 41 subjects with the diagnoses transsexualism (TS) or borderline personality disorder (BPD) and a non-patient group (NP). The overall results showed that, by means of a pattern analysis of 130 DMT variables and partial least squares (PLS) discriminant analysis, it was possible to separate these diagnostic groups. A two-dimensional model seemed to be powerful. The quality and the complexity of the self and object representations have to be considered both from a structural/reality-oriented and from an affective perspective. The most characteristic properties of the TS group were high threshold values for perception, including difficulty in perceiving the threat in the stimulus picture, lack of emotional manifestations, and some projection and introjection responses. With regard to the BPD group, a discontinuity of the ...

Psychodynamic features in borderline personality disorder identified by a subliminal test, the Defense Mechanism Test.

Twenty seven psychiatric inpatients, diagnosed according to DSM‐III and the Diagnostic Interview for Borderline (DIB), and 7 healthy controls were tested with the Defense Mechanism Test (DMT), a test of subliminal perception based on psychoanalytic theory. In the test a specific stimulus is presented subliminaily in a tachistoscope and the patients perceptual distortions are registered. Patients with borderline personality disorder (BPD) were compared with patients with other personality disorders, patients with schizophrenic disorders and healthy controls. Specific perceptual distortions were identified among patients with BPD. Some individual DMT signs correlated with some deviant behaviors as identified by the DIB. The findings supported the psychodynamic validity of the concept of borderline personality disorder. It is concluded that DMT is a promising research instrument that provides an empirical approach to crucial psychodynamic phenomena.

Distress after a single violent crime: how shame-proneness and event-related shame work together as risk factors for post-victimization symptoms.

To increase understanding of post-victimization symptom development, the present study investigated the role of shame- and guilt-proneness and event-related shame and guilt as potential risk factors. 35 individuals (M age = 31.7 yr.; 48.5% women), recently victimized by a single event of severe violent crime, were assessed regarding shame- and guilt-proneness, event-related shame and guilt, and post-victimization symptoms. The mediating role of event-related shame was investigated with structural equation modeling (SEM), using bootstrapping. The guilt measures were unrelated to each other and to post-victimization symptoms. The shame measures were highly intercorrelated and were both positively correlated to more severe post-victimization symptom levels. Event-related shame as mediator between shame-proneness and post-victimization symptoms was demonstrated by prevalent significant indirect effects. Both shame measures are potent risk factors for distress after victimization, whereby part of the effect of shame-proneness on post-victimization symptoms is explained by event-related shame.