Robert M. Weinryb

Stability and predictive ability of personality traits across 9 years

Abstract In the present study, personality traits, as assessed by the Karolinska Scales of Personality (KSP) were found to be stable after 9 years, both with regard to mean level stability (absolute stability) and rank-order stability (relative or differential stability). Moreover, outcome scales were applied measuring either perceptions of satisfaction or scales measuring functioning. Personality scales (from the Eysenck Personality Questionnaire and the KSP) completed in 1986/1987 were associated with measures (completed in 1995/1996) of satisfaction and functioning of family life, emotional and physical health, and work. Specifically, neuroticism-related personality traits predicted a lack of satisfaction with health, but not functional problems due to health. In contrast, neuroticism-related personality traits predicted poor functioning but not satisfaction with family life and work.

Karolinska psychodynamic profile : KAPP

Weinryb RM, ROssel RJ: Karolinska Psychodynamic Profile ‐ KAPP. Acta Psychiatr Scand 1991:83 (suppl 363):l‐23.

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.

The Karolinska Psychodynamic Profile. I. Validity and dimensionality

The Karolinska Psychodynamic Profile (KAPP) is a new rating instrument based on psychoanalytical theory that is intended to assess relatively stable modes of mental functioning, as they appear in self‐perception and in interpersonal relations. The 18 subscales of the KAPP and their scale steps are described in detail. The information needed for assessment is obtained through a structural interview procedure. The KAPP can discriminate between patients with and without a DSM‐III diagnosis. It does not appear to be sensitive to the strain of a major life event. Comparison between interview‐based ratings and projective test‐based ratings shows satisfactory agreement and similarities in factor structure. The KAPP appears to possess both discriminative and construct validity.

The Karolinska Psychodynamic Profile. II. Interdisciplinary and cross-cultural reliability

The Karolinska Psychodynamic Profile (KAPP) is a rating instrument based on psychoanalytical theory, that is intended to assess relatively stable modes of mental functioning, as they appear in self‐perception and in interpersonal relations. The 18 subscales of the KAPP and their scale steps are described in detail and kept close to clinically observable phenomena. The information needed for assessment is obtained through a structural interview procedure. The interrater reliability was tested with different Swedish raters with varying psychodynamic training and experience. It was also tested with a non‐Swedish rater with psychoanalytic training. The interrater correlations were generally high, suggesting that the KAPP has interdisciplinary and cross‐cultural reliability.

PERSONALITY PREDICTORS OF DIMENSIONS OF PSYCHOSOCIAL ADJUSTMENT AFTER SURGERY

Objective Although many studies have examined the relationship between personality factors and adjustment after surgery, most of them have had very short follow-up periods. The present prospective study examines whether preoperative psychodynamic assessment of personality traits enhances prediction of various areas of psychosocial adjustment assessed at least 1 year after surgery. Methods In 53 patients undergoing pelvic pouch surgery for ulcerative colitis, we examined the relationship between personality traits measured before surgery, and postoperative psychosocial adjustment assessed at a median of 17 months postoperatively, controlling for the effect of surgical functional outcome. Personality traits were assessed with the Karolinska Psychodynamic Profile (KAPP). Surgical functional outcome scales and the Psychosocial Adjustment to Illness Scale (PAIS) were used. Results Problems with sexual satisfaction, perfectionistic body ideals, lack of alexithymia, and poor frustration tolerance predicted poor postoperative adjustment in various areas, beyond what was predicted by surgical functional outcome alone. Moreover, moderate preoperative levels of alexithymia were beneficial to postoperative adjustment in the area of psychological distress. Conclusions The findings suggest that the preoperative assessment of the patients long-term sexual functioning and satisfaction, the importance attached to his or her appearance, level of alexithymia, and general capacity to tolerate frustration and set-backs in life, might alert both the surgeon and the patient to potential risk factors for poor postsurgical adjustment.

Stability over time of character assessment using a psychodynamic instrument and personality inventories

In a group of patients with a preoperative diagnosis of ulcerative colitis, the stability of character traits and modes of mental functioning were studied after a major life event, major abdominal surgery, using the Karolinska Psychodynamic Profile (KAPP), an interview‐based assessment instrument founded upon psychoanalytic theory. In addition, different personality and temperamental variables were assessed with 2 self‐report instruments. The patients were assessed before surgery, and follow‐up was made at least 1 year after their final scheduled surgery. Although the patients had undergone major abdominal surgery and convalescence between the assessments, the correlations between the scores before and after surgery were very high, and the levels of the scores were very similar. This was true for all the instruments, indicating that they assessed stable characteristics in the patients. The changes that did occur were mainly in the predicted direction. The results of this study suggest that the KAPP can assess modes of mental functioning and character traits that are relatively stable and only slowly variable.

The concept of alexithymia: an empirical study using psychodynamic ratings and self-reports

In patients with ulcerative colitis, alexithymia and related traits were studied using the Karolinska Psychodynamic Profile (KAPP), a recently constructed psychodynamic assessment instrument, and other measures of alexithymia (the Schalling‐Sifneos Personality Scale (SSPS) and the Beth Israel Questionnaire (BIQ)), and other personality traits using the Karolinska Scales of Personality (KSP). The results of these measures were analyzed for correlation. The prevalence of mental disorder as defined by DSM‐III was not above normal, and the KSP T‐scores were within normal limits. As rated with the KAPP, alexithymia was uncorrelated with age or level of education, but was inversely correlated with proximity to a major life event (abdominal surgery), suggesting that alexithymia may have a defensive function. Cluster analysis, with Regression in the service of the ego (R), Alexithymia (A) and Normopathy (N) as clustering variables, yielded 3 groups: normal, multidisturbed (problems with R, A and N) and inhibited (problems with R and N). SSPS failed to distinguish between the multidisturbed and the inhibited groups, and BIQ between any groups. In the multidisturbed group, correlations were found with detachment and with disturbances in interpersonal relations. The results suggest that disturbances in object relations are of major importance in alexithymia.

Change After Long-Term Psychoanalytic Psychotherapy:

Psychoanalytic psychotherapy in clinical practice is traditionally a long-term treatment conducted by well-trained psychotherapists. However, very few studies have been published that evaluate the effects of such treatment. To redress this lack of studies, 55 individuals selected for long-term psychoanalytic psychotherapy (average, 3 years) were invited to participate in a naturalistic study. The psychotherapists had a mean of 15 years of professional experience. The 36 patients who completed psychotherapy manifested a substantial reduction in symptomatic suffering and decreased levels of character pathology, as measured by the Karolinska Psychodynamic Profile (KAPP) and the Karolinska Scales of Personality. Generally, such changes were not found in the individuals who did not engage in treatment. In the therapy group, improvements were found on eight KAPP subscales defining different aspects of character: Intimacy and Reciprocity, Frustration Tolerance, Regression in the Service of the Ego, Coping with Aggressive Affects, Conceptions of Bodily Appearance and their Significance for Self-esteem, Sexual Function, Sexual Satisfaction, and Personality Organization. The results indicate that individuals who engaged in psychotherapy improved their capacity to handle crucial aspects of life and reduced their symptomatic suffering.

Psychological distress and functional impairment in patients with personality disorders

The study is aimed at investigating the impact of a personality disorder (PD) diagnosis, in terms of functional impairment and subjective distress, in order to better understand the burden of this diagnosis and its implications. Among the 462 consecutive psychiatric patients diagnosed with the DSM structured interview for Axis I, II and V diagnoses, almost 60% had PD. Patients with PD displayed considerable vulnerability and suffering in many domains, including finances and interpersonal relationships. Despite the educational and occupational similarities of PD patients and non-PD patients, the PD patients had more problems maintaining permanent job positions. They also had more symptomatic suffering and concerns about health than non-PD patients. Generally, the results were in line with findings in the literature but more thoroughly captured the challenges that PD patients face in various areas of life. Awareness of the frequent comorbidity of PD with Axis I disorders seems crucial in developing future treatment plans with an emphasis on psychosocial rehabilitation, vocational training and social support.