Dissociation is R elated to Self-Directedness and Self-Transcedence Character Traits

1. Dissociation is Related to Self-Directedness and Self-Transcedence Character Traits in Obsessive-Compulsive Disorder Raszka Michal1, 2, Praško Ján1-4, Kopřivová Jana1-3 1Prague Psychiatric Centre 2Charles University, 3rd Faculty of Medicine, Prague, 3 Centre of neuropsychiatric studies, Prague 4 The Department of Psychiatry, Faculty of Medicine, Olomouc http://www.pcp.lf3.cuni.cz/pcpeng/♦ raszka@pcp.lf3.cuni.cz INTRODUCTION Previous studies revealed that patients with obsessive-compulsive disorder(OCD) had specific differences in temperament and character patterns of Cloninger´s personality dimensional model in comparison with healthy comparison subjects (Pfohl et al. 1990, Richter et al. 1996, Bejerot et al. 1998, Lyoo et al. 2001). Self-transcedence and self-directedness were significant and independent predictors for the level of dissociation in patients with different psychiatric conditions (Grabe et al. 1999). Several studies pointed at the impact of dissociation on the change in therapeutic process (Rufer et al. 2006). Is dissociation associated with personality features in OCD patients? Table 1.Comparison of sociodemographic and clinicalcharacteristics of subjects with OCD and healthy comparison subjects • AIMS OF THE STUDY • 1) To detect the personality features characteristic for OCD • 2) To determine relation of the personality features to the frequency of dissociative • experiences in OCD patiens • Hypotheses • OCD patients have higher harm avoidance scores and lower novelty seeking scores in temperament scales and lower scores of self-directedness and cooperativness in character scales compared to healthy subjects • Self-transcedence and self-directedness scores predict the level of dissociation Results are reported as account or mean ± SD. Abbreviations: DES - Dissociative Experiences Scale, BAI - Beck Anxiety Inventory, BDI-II - Beck Depressive Inventory-II, Y-BOCS -Yale-Brown Obsessive-Compulsive Scale, NS - non significant, n.a. - non applicable, 1-Unpaired t-test, 2 - Pearson's chi-squared test • RESULTS • 1) OCD patients had higher scores in harm avoidance dimension and lower scores in novelty seeking, self-directedness and cooperativness dimensions of Cloningerˇs Temperament and Character Inventory in comparison with healthy controls (Figure 1.) • 2) Level of dissociation in OCD group was predicted by: • self-directedness score (ß = - 0,34 ;t = - 3, 2; p < 0,01) • self-transcedence score (ß = 0,48 ;t = 4,6; p < 0,001) • 3) Level of dissociation in OCD and control group was • predicted by severity of depressive symptoms • (ß = 0,48 ;t = 4,6; p < 0,001) • The severity of OCD symptoms did not predict the level of dissociation in OCD group. Self-directedness and self-transcedence scores did not predict the level of dissociaton in comparison group. • METHODS • Participants • Forty-three patients with OCD diagnosed according to the Mini-International Neuropsychiatric Interview for DSM-IV axis I disorders • Exclusion criteria: comorbid disorder on the axis I with the exception of other anxiety disorders in the last 6 months, organic brain disorder, substance abuse or dependency, severe somatic disorder • Forty-four healthy comparison subjects • Measures • Temperament and Character Inventory (TCI) • Dissociative Experiences Scale (DES) - 28-item subjective scale, range 0–100 • Beck Anxiety Inventory (BAI) - self-administered 21-item scale, range 0–63 • Beck Depression Inventory-II (BDI-II)- self-administered 21-item scale, range 0–63 • Yale-Brown Obsessive-Compulsive scale (Y-BOCS) - the clinician-evaluated 10-item scale, • range 0–40 • Statistics • Unpaired t-test with correction and multiple linear regression (DES score as dependent variable, • all TCI dimensions, Y-BOCS, BAI and BDI as independent variables) analysis were performed. DISCUSSION Previous research on the relationship between the personality features and treatment outcome reported that high level of harm avoidance and low level of self-directedness predict poor response to antidepressants and cognitive behavioral therapy. Worse outcome after cognitive behavioral therapy in OCD patients was predicted by higher level of dissociation at baseline (Rufer et al. 2006). Further studies that link the characteristic personality features and dissociation in OCD subjects to their possible clinical implications are recommended. Figure 1. Novelty Seeking (NS), Harm Avoidance (HA), Self-Directedness (SD),and Cooperation (CO) Dimensions differ in Obsessive-Compulsive Disorder Subjects compared with Healthy Controls (p < 0,05) * * * * CONCLUSIONS Our data confirm that OCD patients have specific personality features (higher harm avoidance and lower novelty seeking, self-directedness and cooperativness). 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