J. Petter Gustavsson

Swedish universities Scales of Personality (SSP): construction, internal consistency and normative data

Objective: A thorough revision of the Karolinska Scales of Personality (KSP) was made by reducing the number of items and improving the psychometric quality as concerns face validity, internal consistency and response differentiation. The revised version was labelled The Swedish universities Scales of Personality (SSP) and now include 91 items divided into 13 scales.

Using the Rasch model in nursing research: An introduction and illustrative example

OBJECTIVE The purpose was to introduce the Rasch model by showing an application in nursing research. METHODS The Rasch model was used to examine the psychometric properties of the nursing self-efficacy (NSE) scale. Data were collected among nursing students in Sweden. Two sets of items were analysed more thoroughly: an original set of nine items with eleven response categories and a revised set of seven items with seven response categories. Invariance of the item functioning and the categorisation of the items were analysed. Targeting was examined by comparisons of the items and persons locations. Differential Item Functioning across sample groups such as gender was examined using analysis of variance. The final set of seven items was also analysed more closely with respect to possible multidimensionality and response dependence. RESULTS The Rasch analysis of the original set of nine items showed high reliability measured by a person separation index, but it also indicated severe problems with the targeting, the categorisation of the items as well as lack of invariance. Although the revised set comprising seven items with seven categories performed better than the original item set some items showed misfit according to formal test statistics. Graphical examination showed, however, that the items operated in the right direction. The formal test of local independence of the items indicated minor signs of multidimensionality, alternatively response dependence. CONCLUSIONS The Rasch model is useful for rigorous examination and development of measurement instruments in nursing research. The Rasch model facilitates disclosure of lack of invariance and other measurement problems that may not be easily detected by traditional analyses. Hence, the NSE-scale would probably have performed much better if the developmental work had been guided by Rasch analyses. In future work on the scale, priority should be given to improving the targeting and the categorisation of the items.

A promoter polymorphism in the monoamine oxidase A gene and its relationships to monoamine metabolite concentrations in CSF of healthy volunteers.

Concentrations of monoamine metabolites (MM) in lumbar cerebrospinal fluid (CSF) have been used extensively as indirect estimates of monoamine turnover in the brain. We investigated possible relationships between a putative functional promoter polymorphism in the monoamine oxidase A (MAOA) gene and CSF concentrations of homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA), and 3-methoxy-4-hydroxyphenylglycol (MHPG) in healthy volunteers (n=88). Among women (n=37), those carrying at least one copy of the alleles associated with more efficient transcription displayed higher concentrations of HVA (p=0.01) and 5-HIAA (p=0.01). In men (n=51), however, there was a tendency in the opposite direction. The results suggest that MAOA genotypes may participate differentially in the regulation of dopamine and serotonin turnover rates under presumed steady state in the central nervous system. The results should be interpreted with caution until replicated because of the limited sample size.

Dopamine-related genes and their relationships to monoamine metabolites in CSF

Monoamine metabolite (MM) levels in lumbar cerebrospinal fluid (CSF) are extensively used as indirect estimates of monoamine turnover in the brain. In this study we investigated genotypes for DNA polymorphisms in the D2 (DRD2), D3 (DRD3), and D4 (DRD4) dopamine receptor and tyrosine hydroxylase (TH) genes and their relationships to CSF MM in healthy volunteers (n = 66). Concentrations of homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylglycol (MHPG), and 5-hydroxyindoleacetic acid (5-HIAA) were corrected for back length, a confounding variable. Corrected MM levels were not related to age, gender, height, weight heredity, season or atmospheric pressure at sampling. Individuals with specific DRD2 and TH allele and genotype configurations significantly differed in HVA and MHPG concentrations. DRD3 homo- and heterozygotic genotypes had significantly different CSF 5-HIAA levels. DRD4 genotypes were not related to MM concentrations. The results suggest that specific DRD2, DRD3, and TH genotypes participate in the regulation of monoamine turnover in the central nervous system. Accordingly monoamine receptors and synthesizing enzyme genotypes appear to be variance factors influencing MM concentrations in CSF. The relationships found in this study support MM concentrations as markers for monoamine transmission in the human brain.

Psychometric properties of scales in the General Nordic Questionnaire for Psychological and Social Factors at Work (QPSNordic) : confirmatory factor analysis and prediction of certified long-term sickness absence

Psychometric properties, particularly predictive validity, of scales in the General Nordic Questionnaire for Psychological and Social Factors at Work (QPS(Nordic)) were assessed. The analysis is confined to the scales in the QPS(Nordic,) and 24 of the 26 scales are included. A large group of Swedish county council employees (n= 3,976; response rate = 65%) participated in a study and were given the QPS(Nordic). Register data for long-term sick leave (>90 days), with diagnosis, were used for predictive analysis. The following main results were obtained: Reliability was generally satisfactory, confirmatory factor analysis indicated good fit, concurrent validity was good, some less often investigated organizational variables predicted sickness absence, and scales were differentially associated with absence due to psychiatric and musculoskeletal disorders. In conclusion, the psychometric testing of the QPS(Nordic) so far suggests that it is a good instrument for assessing health-related factors at work.

Polymorphisms in the dopamine, serotonin, and norepinephrine transporter genes and their relationships to monoamine metabolite concentrations in CSF of healthy volunteers

Concentrations of monoamine metabolites (MM) in lumbar cerebrospinal fluid (CSF) have been used extensively as indirect estimates of monoamine turnover in the brain. We investigated the possible relationships between DNA polymorphisms in the dopamine transporter (DAT), serotonin transporter (SERT), and norepinephrine transporter (NET) genes and CSF concentrations of homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA), and 3-methoxy-4-hydroxyphenylglycol (MHPG) in healthy volunteers (n = 66). The DAT polymorphism was not significantly associated with any of the monoamine metabolites, but a tendency for relationship with 5-HIAA was found in women. For both of the two SERT polymorphisms investigated, a functional promoter polymorphism and an intronic polymorphism without known function, significant relationships were found with CSF MHPG levels. No relationship was found between the SERT polymorphisms and CSF HVA and 5-HIAA. The NET polymorphism was associated with CSF MHPG levels but not HVA and 5-HIAA concentrations. The results suggest that SERT and NET genotypes may participate differentially in the regulation of the norepinephrine turnover rate under presumed steady-state conditions in the central nervous system. As only limited data so far indicate interactions between the serotonin and norepinephrine systems in the brain, and the NET polymorphism investigated is not known to be of functional significance, the results should be interpreted with caution until replicated.

Burnout during nursing education predicts lower occupational preparedness and future clinical performance: A longitudinal study

BACKGROUND Early-career burnout among nurses can influence health and professional development, as well as quality of care. However, the prospective occupational consequences of study burnout have not previously been investigated in a national sample using a longitudinal design. OBJECTIVES To prospectively monitor study burnout for a national sample of nursing students during their years in higher education and at follow-up 1 year post graduation. Further, to relate the possible development of study burnout to prospective health and life outcomes, as well as student and occupational outcomes. DESIGN A longitudinal cohort of Swedish nursing students (within the population-based LANE (Longitudinal Analysis of Nursing Education/Entry) study) from all sites of education in Sweden was surveyed annually. Data were collected at four points in time over 4 years: three times during higher education and 1 year post graduation. PARTICIPANTS : A longitudinal sample of 1702 respondents was prospectively followed from late autumn 2002 to spring 2006. METHODS Mean level changes of study burnout (as measured by the Oldenburg Burnout Inventory, i.e. the Exhaustion and Disengagement subscales) across time, as well as prospective effects of baseline study burnout and changes in study burnout levels, were estimated using Latent Growth Curve Modeling. RESULTS An increase in study burnout (from 30% to 41%) across 3 years in higher education was found, and levels of both Exhaustion and Disengagement increased significantly across the years in education (p<0.001). Baseline levels, as well as development of study burnout, predicted lower levels of in-class learner engagement and occupational preparedness in the final year. At follow-up 1 year post graduation, earlier development of study burnout was related to lower mastery of occupational tasks, less research utilization in everyday clinical practice and higher turnover intentions. CONCLUSIONS The results suggest that study burnout may have interfered with learning and psychological well-being. Aspects related to work skills and intention to leave the profession were also affected. Thus, burnout development during higher education may be an important concern, and effective preventive measures to counteract burnout development may be necessary already at the outset of nursing education.

No association between serotonin transporter gene polymorphisms and personality traits

Human family and twin studies have established considerable heritable components in personality traits as assessed by self-report questionnaires. Recently, an association between a functional polymorphism in the upstream regulatory region of the serotonin transporter gene and neuroticism-related personality traits was reported. Two different serotonin transporter polymorphisms including the previously associated variant were genotyped in two samples of healthy Swedish subjects (n = 127 and n = 178, respectively) assessed with the Karolinska Scales of Personality (KSP) inventory. No statistically significant association between serotonin transporter polymorphisms and any of the eight neuroticism-related KSP scales was found. Thus, the previously reported association between serotonin transporter alleles and neuroticism-related personality traits could not be replicated in the present study.

The HP5 inventory: definition and assessment of five health- relevant personality traits from a five-factor model perspective

Abstract The aim of the present project was to construct a short personality inventory specifically applicable in personality and health research. The development began with a demarcation of some specific constructs thought to be relevant in explaining individual differences influencing the vulnerability to illness and illness progression as well as psychosocial adaptation to illness. Factor analytic procedures were used separately in two different samples to derive the scales from an item pool. Two confirmation samples were used in addition for cross-validating the final model. In addition, scales from other personality inventories were used to further validate the new scales. A total of 20 items were chosen to constitute the new instrument, entitled the HP5i (H for Health-relevant; P for personality; 5 for its correspondence with the FFM taxonomy; and i for inventory). The five scales were labeled Antagonism (as a facet of Agreeableness), Impulsivity (as a facet of Conscientiousness), Hedonic Capacity (as a facet of Extraversion), Negative Affectivity (as a facet of Neuroticism), and Alexithymia (as a facet of Openness). The new HP5 inventory Scales manifested a meaningful pattern of correlations with NEO PI-R Scales and with two alexithymia scales, thus suggesting some preliminary empirical evidence for convergent validity.

Association between a promoter dopamine D2 receptor gene variant and the personality trait detachment

BACKGROUND Personality traits have shown considerable heritable components. Striatal dopamine D(2) receptor density, as determined by positron-emission tomography, has been associated with detached personality, as assessed by the Karolinska Scales of Personality. A putative functional promoter polymorphism in the dopamine D(2) receptor gene (DRD2), -141C ins/del, has been associated with dopamine D(2) receptor density. METHODS In this study healthy subjects (n = 235) who filled in at least one of several personality questionnaires (Karolinska Scales of Personality, Swedish Universities Scales of Personality, Health-relevant Five-factor Personality Inventory, and Temperament and Character Inventory) were analyzed with regard to the DRD2 -141C ins/del variant. RESULTS There was an association (p =.001) between the DRD2 -141C ins/del variant and Karolinska Scales of Personality Detachment scale, indicating higher scores in subjects with the -141C del variant. There were also associations between the DRD2 -141C ins/del variant and a number of Karolinska Scales of Personality and Swedish Universities Scales of Personality Neuroticism-related scales, but of these only Swedish Universities Scales of Personality Lack of Assertiveness scale (p =.001) survived correction for multiple testing. CONCLUSIONS These results add further support for the involvement of dopamine D(2) receptor in certain personality traits. The results should be treated with caution until replicated.