Journal articles on the topic 'Personality-Disease Link'

The pioneering work of the authors of the Type A personality concept has now been shown to be seriously flawed, with only the traits of anger, aggression, and hostility remaining as risk factors for coronary heart disease (CHD). There is now evidence for a much stronger relationship between CHD and personality involving a rather different set of concepts and theories. The evidence for such a relationship is summarized, and a causal link suggested. It is also shown that the CHD‐prone type of behaviour can be changed by behaviour therapy, decreasing considerably the risk of dying from CHD.

Objective The Type A personality, characterized by impatience, strong career ambition and competitiveness, is associated with greater sensitivity to external stress. Type 1 diabetes (T1D) is an auto-immune disease, which is potentially influenced by stress, unlike type 2 diabetes (T2D). The aim of this study was to assess whether individuals with T1D and T2D exhibited significant differences on the Type A personality scale. We also assessed personality in patients with thyroid auto-immune diseases to validate potential links between auto-immune disease and Type A personality. Design and methods The Bortner questionnaire was used to assess Type A personality in 188 patients with T1D, 430 patients with T2D and 85 patients with auto-immune thyroid disease (Graves’ disease or Hashimoto’s thyroiditis). Results Type A Bortner scores were significantly higher in T1D patients than in T2D patients (188 ± 34 vs 177 ± 36, P < 0.0001). Patients with auto-immune thyroid diseases and T1D patients had similar Type A Bortner scores (189 ± 33 vs 188 ± 34, P = 0.860). Conclusion Patients with auto-immune T1D have higher Type A scores than T2D patients. Furthermore, patients with auto-immune thyroid disease also have elevated Type A scores similar to those observed in type 1 diabetes, suggesting that an elevated Type A score in T1D is potentially related to its auto-immune origin. This suggests a possible link between Type A personality and auto-immune diseases via stress-triggering psychobiological pathways. The different personality score between T1D and T2D is an important factor, which could influence self-care coping strategies in diabetes and long-term prognosis.

SynopsisThis quasi-prospective study of 2163 women attending breast-screening clinics (and controls), indicates that there is a link between personality factors and breast disease. Certain aspects of Type A behaviour seem to be associated with breast-disease states.

Alzheimer’s disease (AD) is the most common form of dementia in the elderly. This neurodegenerative disorder is clinically characterized by impairment of cognitive functions and changes in behaviour and personality. The pathogenesis of AD is still unclear. Recent evidence supports some role of mitochondria dysfunction and oxidative stress in the development of the neurodegenerative process. In this review, we discuss the role of mitochondrial dysfunction in AD, focusing on the mechanisms that lead to mitochondrial impairment, oxidative stress, and neurodegeneration, a “vicious circle” that ends in dementia.

Background: The link between personality traits and employment status in individuals with chronic health conditions (CHCs) is largely unexplored. In this study, we examined this association among 21,173 individuals with CHCs and whether this association differs between individuals suffering from a heart disease, depression, anxiety, cancer, chronic obstructive pulmonary disease, musculoskeletal disease (MSD) and type 2 diabetes mellitus (T2DM). Methods: This study was conducted using baseline data from the Lifelines Cohort Study. Employment status and the presence of CHCs were determined by questionnaire data. The Revised Neuroticism-Extroversion-Openness Personality Inventory (NEO-PI-R) was used to measure eight personality facet traits. We conducted disease-generic and disease-specific logistic regression analyses. Results: Workers with higher scores on self-consciousness (OR: 1.02; 95% CI: 1.01–1.02), impulsivity (1.03; 1.02–1.04), excitement seeking (1.02; 1.01–1.02), competence (1.08; 1.07–1.10) and self-discipline (1.04; 1.03–1.05) were more often employed. Adults with higher scores on anger-hostility (0.97; 0.97–0.98), vulnerability (0.98; 0.97–0.99), and deliberation (0.96; 0.95–0.97) were least often employed. Personality facets were associated strongest with employment status among individuals suffering from MSD and weakest in individuals with T2DM. Conclusions: Personality might be a key resource to continue working despite having a CHC. This may be relevant for the development of targeted personality-focused interventions.

Background and Objectives: to investigate the current state of art in the study of personality disorders in central serous chorioretinopathy (CSC), also taking into account the dimensional approach. Materials and Methods: this systematic review was conducted according to PRISMA guidelines. We included articles written in English or Italian, published in peer reviewed journals from 1 January 2010 to 31 December 2020. Results: after the screening, 10 studies were included. The results suggest that CSC patients are not characterized by the prevalence of a formal personality disorder, but they are better explained by typical personality traits that may alter their relationship with others. CSC patients seems to be characterized by high levels of aggressiveness and anxiety traits along with low sociability. We propose a model of disease where stress exacerbates prior specific traits in a vicious circle where some traits might be involved in disease progression and manifestation. Conclusions: maladaptive personality traits might be an essential feature of the disease and may represent a possible link between psychiatric symptoms, such as insomnia, anxiety, and depression, and endocrinological patterns. Further research should use a specific assessment scale evaluating both the level of interpersonal functioning and specific maladaptive traits.

Recent research addressing the link between psychological factors and risk of coronary heart disease (CHD) has focused on the areas of hostility and anger and produced sometimes contradictory results. This study makes use of four questionnaire measures of hostility and anger, which were administered to matched groups with and without CHD. Quicker experiences of anger with greater verbal expression best predicted CHD. The difficulties in teasing out the relative contributions of emotional expression, experience and personality using available questionnaires are discussed.

Aim. To evaluate the type D personality relation with clinical and instrumental parameters in patients with coronary heart disease (CHD) underwent coronary stenting (CS) and to determine the influence of the personality type D on the prognosis in these patients within one year after CS. Material and methods. Into prospective study we included 977 patients (740 men and 237 women) aged 33 to 86 years (mean age 58.7±9.4) who underwent CS. The Cox proportional hazard regression model was used to estimate the relative risk (RR) with a 95% confidence interval (CI) of the end point. The end points included death from all causes, death from cardiovas- cular disease (CVD), myocardial infarction (fatal + non-fatal) (MI), non-fatal myocardial infarction (non-fatal MI), unstable angina (UA), and stroke. Results. Type D personality was found in 31.8% patients. These did not differ from the others in terms of age, gender, main cardiovascular risk factors. Patients of D-type had tendency to the increase of diabetes diagnosed – 25.1% vs 20.3% (p=0.09). At the same time D-type patients had more prevalent ≥2 myocardial infarction in anamnesis – 9.0% vs 4.5% (p=0,006) among those with post infarction cardiosclerosis. There was no difference between the groups according to echocardiography and the short-term outcomes of CS. During the prospective study period (12±1.8 months) 24 patients (2.4%) died from all causes, 21 patients (2.1%) died from CVD. MI developed in 47 patients (4.8%) of whom, 23 patients (2.4%) underwent non-fatal MI. In 50 patients (5.1%) ischemic heart disease in a prospective period complicated UA. In 8 patients (0.8%) developed a stroke. There was no effect of personality type D on the prognosis in patients with CHD who underwent CS for 1 year after surgery. Conclusion. Among CHD patients underwent CS, type D personality was found in 31.8%. There is no link for type D personality and severity of CHD clinically as well as the short-term and long-term outcomes of CS.

Animal behaviour and the ecology and evolution of parasites are inextricably linked. For this reason, animal behaviourists and disease ecologists have been interested in the intersection of their respective fields for decades. Despite this interest, most research at the behaviour–disease interface focuses either on how host behaviour affects parasites or how parasites affect behaviour, with little overlap between the two. Yet, the majority of interactions between hosts and parasites are probably reciprocal, such that host behaviour feeds back on parasites and vice versa. Explicitly considering these feedbacks is essential for understanding the complex connections between animal behaviour and parasite ecology and evolution. To illustrate this point, we discuss how host behaviour–parasite feedbacks might operate and explore the consequences of feedback for studies of animal behaviour and parasites. For example, ignoring the feedback of host social structure on parasite dynamics can limit the accuracy of predictions about parasite spread. Likewise, considering feedback in studies of parasites and animal personalities may provide unique insight about the maintenance of variation in personality types. Finally, applying the feedback concept to links between host behaviour and beneficial, rather than pathogenic, microbes may shed new light on transitions between mutualism and parasitism. More generally, accounting for host behaviour–parasite feedbacks can help identify critical gaps in our understanding of how key host behaviours and parasite traits evolve and are maintained.

The paper deals with methodological issues related to the link between the processes of forming the internal picture of the disease and coping behavior in the dynamics of the subjective and objective factors of the psychosocial functioning of the personality. From our point of view, there are significant stages, implying the association of the components of the internal picture of the disease, as well as the personal meaning of health and coping behavior. The variants of their interdependence in the structure of the integral adaptation process are considered, which, in turn, determines the patient’s essential understanding and assessment of the quality of life (QOL) in the actual life situation.

Background: There is a proven link between Down syndrome and the early development of the neuropathological features of Alzheimer's disease (AD). Changes in the personality and behavior of adults with Down syndrome might indicate the early stages of dementia or of frontotemporal lobar degeneration. The objective of this study was to investigate the executive functions and changes in behavior associated with frontal lobe degeneration in individuals with Down syndrome who develop AD. We conducted a systematic review selecting studies employing cognitive assessments. Summary: We identified few studies using objective measurements to determine whether cognitive aspects associated with the frontal lobe correlate with dementia in this population. We observed a tendency toward such correlations. Key Messages: There is a need for further studies in which objective measures of cognitive and behavioral factors are evaluated together with data related to brain function and morphology.

Multiple sclerosis (MS) is a chronic neurological disease whose etiology has not been fully understood yet in detail. Empirical findings show how psychosocial symptoms are very important features of the clinical presentation of MS, having a deep impact on patient's quality of life, and thus psychological coping strategies may play a central role in reducing the burden of the disease and improving patient's satisfaction of life. MS progression and relapses/exacerbations are unpredictable and may depend on factors such as stressor chronicity, frequency, severity, type, and individual patient characteristics such as depression, personality, locus of control (LOC), optimism, and perceived social support. Due to its importance for health-care delivery, rehabilitation, and nursing, here, we make a systematic review on the current state-of-the-art studies concerning the relationship between LOC and MS, according to the PRISMA guidelines, and we assess the quality and the completeness of the studies using the CONSORT instrument, underpinning their limitations, and suggesting how to fill the gap in this research field.

Even though there is a clear link between Alzheimer’s Disease (AD) related neuropathology and cognitive decline, numerous studies have observed that healthy cognition can exist in the presence of extensive AD pathology, a phenomenon sometimes called Cognitive Resilience (CR). To better understand and study CR, we develop the Alzheimer’s Disease Cognitive Resilience Score (AD-CR Score), which we define as the difference between the observed and expected cognition given the observed level of AD pathology. Unlike other definitions of CR, our AD-CR Score is a fully non-parametric, stand-alone, individual-level quantification of CR that is derived independently of other factors or proxy variables. Using data from two ongoing, longitudinal cohort studies of aging, the Religious Orders Study (ROS) and the Rush Memory and Aging Project (MAP), we validate our AD-CR Score by showing strong associations with known factors related to CR such as baseline and longitudinal cognition, non AD-related pathology, education, personality, APOE, parkinsonism, depression, and life activities. Even though the proposed AD-CR Score cannot be directly calculated during an individual’s lifetime because it uses postmortem pathology, we also develop a machine learning framework that achieves promising results in terms of predicting whether an individual will have an extremely high or low AD-CR Score using only measures available during the lifetime. Given this, our AD-CR Score can be used for further investigations into mechanisms of CR, and potentially for subject stratification prior to clinical trials of personalized therapies.

BackgroundDysfunctions in the regulation of emotional responses are related to poor psychological well-being and increased impact of cardiovascular disease. It has been suggested that the relationship between negative affect and higher morbidity could be mediated by a dysregulation of the autonomic nervous system (ANS), for example, of heart rate variability (HRV). Neuroticism is a personality trait associated with a maladaptive emotion regulation and also with alterations in ANS function. However, it is unknown whether subjects with high neuroticism present with specific biases in emotion regulation associated with reduced HRV.MethodIn total, 33 healthy subjects (n=13, highly neurotic) performed an emotion regulation task, during which they were instructed to either passively view negative pictures or attempt to down-regulate the affect elicited by the images. During the task an electrocardiogram was recorded and HRV was measured by calculation of the high frequency spectrum (HF-HRV).ResultsA significant interaction between task condition and personality group was observed on HF-HRV measures (F1,31=6.569, p=0.016). This was driven by subjects with low neuroticism presenting higher HF-HRV during down-regulation compared to passive exposure to negative stimuli, while subjects with high neuroticism reported an opposite tendency.ConclusionsOur results show reduced HF-HRV during cognitive reappraisal of negative stimuli in high neuroticism and indicate a specific link between loss of flexibility in the parasympathetic cardiovascular tone and emotion regulation, consistent with previous work. Such findings support the importance of exploring the combination of ANS adaptability and emotional dysregulation in neuroticism as different facets of a common psychosomatic vulnerability factor.

Humans and other animals are motivated to act so as to maximize their subjective reward rate. Here, we propose that reward rate maximization is accomplished by adjusting a context-dependent “urgency signal,” which influences both the commitment to a developing action choice and the vigor with which the ensuing action is performed. We review behavioral and neurophysiological data suggesting that urgency is controlled by projections from the basal ganglia to cerebral cortical regions, influencing neural activity related to decision making as well as activity related to action execution. We also review evidence suggesting that different individuals possess specific policies for adjusting their urgency signal to particular contextual variables, such that urgency constitutes an individual trait which jointly influences a wide range of behavioral measures commonly related to the overall quality and hastiness of one’s decisions and actions. Consequently, we argue that a central mechanism for reward rate maximization provides a potential link between personality traits such as impulsivity, as well as some of the motivation-related symptomology of clinical disorders such as depression and Parkinson’s disease.

AbstractBackgroundMajor depressive disorder and neuroticism (Neu) share a large genetic basis. We sought to determine whether this shared basis could be decomposed to identify genetic factors that are specific to depression.MethodsWe analysed summary statistics from genome-wide association studies (GWAS) of depression (from the Psychiatric Genomics Consortium, 23andMe and UK Biobank) and compared them with GWAS of Neu (from UK Biobank). First, we used a pairwise GWAS analysis to classify variants as associated with only depression, with only Neu or with both. Second, we estimated partial genetic correlations to test whether the depression's genetic link with other phenotypes was explained by shared overlap with Neu.ResultsWe found evidence that most genomic regions (25/37) associated with depression are likely to be shared with Neu. The overlapping common genetic variance of depression and Neu was genetically correlated primarily with psychiatric disorders. We found that the genetic contributions to depression, that were not shared with Neu, were positively correlated with metabolic phenotypes and cardiovascular disease, and negatively correlated with the personality trait conscientiousness. After removing shared genetic overlap with Neu, depression still had a specific association with schizophrenia, bipolar disorder, coronary artery disease and age of first birth. Independent of depression, Neu had specific genetic correlates in ulcerative colitis, pubertal growth, anorexia and education.ConclusionOur findings demonstrate that, while genetic risk factors for depression are largely shared with Neu, there are also non-Neu-related features of depression that may be useful for further patient or phenotypic stratification.

Amyotrophic lateral sclerosis (ALS) is a progressive and lethal disease of motor neuron degeneration, leading to paralysis of voluntary muscles and death by respiratory failure within five years of onset. Frontotemporal dementia (FTD) is characterised by degeneration of frontal and temporal lobes, leading to changes in personality, behaviour, and language, culminating in death within 5–10 years. Both of these diseases form a clinical, pathological, and genetic continuum of diseases, and this link has become clearer recently with the discovery of a hexanucleotide repeat expansion in theC9orf72gene that causes the FTD/ALS spectrum, that is, c9FTD/ALS. Two basic mechanisms have been proposed as being potentially responsible for c9FTD/ALS: loss-of-function of the protein encoded by this gene (associated with aberrant DNA methylation) and gain of function through the formation of RNAfocior protein aggregates. These diseases currently lack any cure or effective treatment. Antisense oligonucleotides (ASOs) are modified nucleic acids that are able to silence targeted mRNAs or perform splice modulation, and the fact that they have proved efficient in repeat expansion diseases including myotonic dystrophy type 1 makes them ideal candidates for c9FTD/ALS therapy. Here, we discuss potential mechanisms and challenges for developing oligonucleotide-based therapy for c9FTD/ALS.

- Authors describe the process which led to the activation of a multi-family group within a Residential Therapeutic Community for young patients with personality disorder, especially in the borderline spectrum. In the perspective of a transforming intervention which is aimed at fostering mentalization processes, authors highlight that a multi-family group works as a safe enlarged container which enables families to question designations and interactive stiff modalities as well as to stimulate new ways of thinking. Moreover, they believe a multi-familiar group represents a meta-context which allows, on the one hand, to integrate and enrich those elements emerging in different therapeutic community contexts (individual, familiar, group), on the other, it favours the attuning of theoretical frameworks which are different, but which share the idea of focusing on relationships and contexts, rather then on the nature of the disease. Then, authors explore feasible articulations with the theorizations made by García Badaracco of the systemic-familiar thought of Bowen (Differentiation of Self) and Bateson (Ecology of Mind) and the attachment theory, with particular reference to the researches which link the pattern of disorganized attachment and the deficit of mentalization functions, to the borderline disorder. Finally, a clinical case has been reported which clearly describes the multifamily group ability to work as an "amplified mind" allowing a person to think together what he or she could not think on her own.

Background. Patients adjust to cancer in a continuous process that follows the course of the disease. Previous research has considered several illness-related variables and demographics, quality of life, personality, and social factors as predictors of adjustment to cancer, which can be maladaptive (e.g., helplessness-hopelessness and anxious preoccupation) or adaptive (e.g., fighting spirit). Aims. Assuming a biopsychosocial view, we test an empirical model in which disease stage, patient’s age, and gender are viewed as the distal antecedents of positive and negative adjustment to cancer for chemotherapy patients. Health-related quality of life (HRQoL) has a key role, interposing between the distal antecedents and adaptational outcomes. Social support and positive thinking are also included in the model as related to adjustment. Methods. One-hundred-sixty-two consecutive cancer patients receiving adjuvant or standard chemotherapy participated in the study. Patients completed the Mini-Mental Adjustment to Cancer, the Brief-COPE, the Social Provision Scale, and the SF-12 Health Survey. Partial least squares structural equation modeling (PLS-SEM) was applied for model building and hypotheses testing. Results. We found a negative association between advanced stage and physical functioning, a strong positive link between physical functioning and mental health, and significant relations between mental health and helpless-hopelessness, anxious preoccupation, and cognitive avoidance. Social support and positive thinking were related to fighting spirit and fatalism. Cancer stage and female gender were indirectly associated with adaptational outcomes through HRQoL. The patient’s age had no significant relationships in the model. Discussion. HRQoL (both physical and mental) is a key factor for preventing maladjustment in chemotherapy patients. Social support and positive thinking coping style fosters fighting spirit and fatalism on health outcomes. Two potential lines of action seem promising: preventing maladaptive and promoting adaptive adjustments working on patient’s mental health individually and involving significant others in supportive care, respectively.

Abstract Sleep is associated with all-cause mortality, cardiovascular disease, cognitive impairment, as well as daily social interactions and productivity. Studies often have focused on sleep duration only, lacking the ability to comprehensively understand the importance of age-related changes in varied facets of sleep health. Moreover, psychological and social factors that may be associated with sleep health in adulthood are still poorly understood. This symposium showcases contemporary endeavors towards understanding how diverse indicators of sleep health relate to psychological and social factors across adulthood. Paper 1 uses perceived job discrimination as a social stressor to test associations between perceived job discrimination and sleep health (difficulty falling/staying asleep, excessive daytime sleepiness, sleep duration) among working women. Paper 2 examines the relationship between personality traits and self-reported and actigraphy-measured sleep health (sleep duration, sleep quality, sleep latency, insomnia symptoms, wake-after-sleep-onset). Paper 3 uses daily diary data to examine the link between pain and sleep health (sleep disturbances, napping) in older adults’ everyday lives and test moderating effect of social support. Paper 4 examines sleep health (sleep latency, feeling unrested) as a mechanism linking physical activity and cognitive function. These papers use different project datasets that include diverse populations of middle-aged and older adults, such as the Sister Study, Midlife in the United States Study, and Daily Experiences and Well-being Study. At the end of these presentations, Dr. Buxton will discuss their theoretical and methodological contributions, and consider challenges and opportunities for future research.

We plan to analyze the psychological and sociological concepts of the other and the role theory. We would describe the roles in psychopathology differentiating between the identity of the role and the identity of oneself and its entailment with the other, with respect to the development of the individual and its difficulties in the acquisition of roles, leading to different clinical entities. These pathologies show phenomenological differences observed in clinical situations such as schizophrenia, depression, bipolar disease, personality disorders and in psychopathological manifestations of epilepsy. We analyze the difficulties schizophrenic patients have in assuming roles, as well as in the recognition of “the other”, depressive patients and their over identification of roles, the link to manic states, and a poor identity observed in patients with hysteria. Special considerations are made in the social interactions of epileptic patients with “the other” which takes the form of “being with”, and the dynamics established by epileptics in their social roles. These characteristics are also found in epileptic psychoses. When a psychotic state ends, and patients recover from a clear or lucid epileptic psychoses, they return to work recovering their social roles and interaction with others. In the case of cognitive impairment and organic dementia, there is a difficult adaptation due to this disability. Experiences lived under the psychotic episode are maintained, even reinforced and influence how they consider themselves and the others, in particular in terms of moral and religious ideas.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Depth of activation reaction (α-activity suppression during the eyes-opening task) is considered to be an important quantitative characteristic of α-band brainwaves. Activation reaction was assessed from O1 and O2 leads in 31 male substance dependent subjects. In 7 cases it was measured twice: before and after α- or β-brainwave biofeedback training. The correlations were found between grade of α suppression in eyes-opening task and attitude towards disease and treatment, personality maturity, and level of pathological personality traits. Activation reaction was significantly improved by α-training and non-significantly diminished after β-1-training.

Although a wide variety of factors have been found to be related to health in some way, researchers on the subject of health generally fail to integrate findings of other research disciplines within their own line of research. This study has attempted to bring together two research disciplines: (a) research on personality and health, and (b) research on socio‐economical differences in health. Personality factors as well as social class have been found to mediate the stress‐illness relation. Based on empirical and theoretical considerations, we proposed a simple model for the occurrence and course of disease. The personality factors studied were neuroticism, locus of control, and self‐esteem. Socio‐economic status (SES) was represented by education level, occupation status, and income. Health was operationalized as the number of somatic diseases. The research questions were investigated (using t‐tests andpath analysis) in a longitudinal set of data that were collected between 1970 and 1984 among 245 subjects in the normal population. Neuroticism appeared to be an important mediator of the stress‐illness relation. Of the SES variables, occupation and education served as mediators; education was especially infuential on the course of disease. The role of neuroticism is discussed.

Parkinson's disease (PD) patients display low novelty seeking scores on the Tridimensional Personality Questionnaire (TPQ), which may reflect the low dopamine function that characterises the disease. People with PD also display raised harm avoidance scores. Due to these and other observations, a “parkinsonian personality” has been suggested. However, little is known about how these features relate to cognitive and affective disorders, which are also common in PD. We examined links between TPQ scores and performance on an attentional orienting task in a sample of 20 people with PD. In addition, associations between TPQ and depression and anxiety scores were explored. It was found that novelty seeking scores were significantly correlated with a reaction time measure of attentional orienting to visual novelty. Harm avoidance scores were significantly correlated with anxiety, but not depression scores. These findings extend our understanding of how temperament interacts with cognitive and affective features of the disorder.

Abstract Abstract 4805 Children with sickle cell anemia (SCA) and a primary overt stroke are at high risk of recurrent (secondary) stroke. Chronic blood transfusion (CBT) dramatically reduces but does not eliminate this high risk, and results in transfusion-related hemosiderosis. We previously reported the use of hydroxyurea/phlebotomy as an alternative to CBT to reduce the risk of secondary stroke and improve management of iron overload (Ware et al. J Pediatr 2004). This study examines the caregiver and child experience with secondary stroke prevention. Individual semi-structured interviews were conducted with primary caregivers and children/adolescents (age > 5 years) recruited from the Duke Pediatric Sickle Cell Program. The interviewer (E.P.) asked about perceptions of risk of recurrent stroke and iron overload with and without therapy and facilitators and barriers of therapy. Interviews were coded and analyzed independently by two investigators (E.P and C.T.). The sample included 14 youth (10 males) with a median age of 12.5 years (range 3–17). All primary caregivers were female. Twelve children had a history of overt stroke and 2 had a history of silent stroke. All children had experience with CBT and 9 were receiving CBT at the time of the interview. Eleven children had experience taking hydroxyurea and 5 were taking hydroxyurea at the time of the interview. All caregivers agreed that their child was at risk of recurrent stroke, identified benefit of current treatment and reported high motivation to adhere to treatment protocols. They noted significant impact that stroke had on school functioning, attention, personality, participation in sports and overall quality of life. Caregiver-reported barriers to CBT and hydroxyurea fell into three main categories: (1) missed work and school and related consequences; (2) unexpected resource-related challenges; and (3) inconvenience of clinic appointments, all of which contributed to burden on the family and sometimes missed clinic appointments and treatments. There were higher levels of concern expressed by caregivers of children on CBT related to the higher frequency and longer length of medical appointments compared with those taking hydroxyurea. The primary child-reported barrier was dislike of needles or shots (although this decreased with age as expected); those taking hydroxyurea also noted that they sometimes forgot to take the medication if they were busy with other activities or fell asleep. Caregiver-reported facilitators of CBT and hydroxyurea included: (1) understanding importance of stroke prevention and connection to consistent treatment; (2) ancillary benefits of treatments in addition to stroke prevention; (3) link between treatment and long-term benefits. Caregivers were able to overcome treatment barriers via the following: (1) logistical supports including appointment and medication reminders; (2) shared responsibility with other family members including the child; (3) trust in medical staff; and (4) faith. Although children disliked needles and shots, many enjoyed the clinic visits due to fun activities in the clinic setting and rewards. In addition, iron overload was a significant concern for caregivers. For those with children on CBT, knowledge of the risks of iron overload motivated adherence with oral iron chelation. Automatic refills facilitated adherence with chelation therapy, but the taste of the medication was a major barrier to adequate iron chelation. Caregivers of children taking hydroxyurea noted the benefit of avoiding iron overload. Of those who had undergone phlebotomy, in-home phlebotomy was noted as a facilitator, though requirement for IV contributed to negative perception. In summary, as clinicians review options for secondary stroke prevention with families, they should discuss family perceptions and individual barriers and facilitators which may impact adherence with therapy and long-term outcome. Future research should also investigate whether these family perceptions predict actual adherence to protocols and treatment outcomes. Disclosures: Off Label Use: Hydroxyurea for secondary stroke prevention in sickle cell disease.

Objective: optimism is an important variable that has consistently been shown to affect adjustment to quality of life in chronic diseases. This study aims to clarify if dispositional optimism exerts a moderating or a mediating influence on the personality traits-quality of life association, in Portuguese chronic patients. Methods: multiple regression models were used to test the moderation and mediation effects of dispositional optimism in quality of life. A sample of 729 patients was recruited in Portugal's main hospitals and completed self-reported questionnaires assessing socio-demographic and clinical variables, personality, dispositional optimism, quality of life (QoL) and subjective well-being (SWB). Results: the results of the regression models showed that dispositional optimism did not moderate the relationships between personality traits and quality of life. After controlling for gender, age, education level and severity of disease perception, the effects of personality traits on QoL and in SWB were mediated by dispositional optimism (partially and completely), except for the links between neuroticism/openness to experience and physical health. Conclusion: dispositional optimism is more likely to play a mediating, rather than a moderating role in personality traits-quality of life pathway in Portuguese chronic patients, suggesting that "the expectation that good things will happen" contributes to a better quality of life and subjective well-being.

Abstract Background Improving understanding of the impact of antibiotic overuse is a key component of the global action plan to address antibiotic resistance. Play is an underutilized opportunity to engage adults in learning about antibiotic resistance and the importance of appropriate antibiotic use in mitigating this public health threat. Our objective was to evaluate the reach of a web-based antibiotic awareness personality quiz. Figure 1. Antibiotic Personality Quiz Participants Methods A personality quiz (http://www.tiny.cc/antibioticquiz) was developed using an online platform (Tryinteract.com). The quiz included a series of short personality-based questions. Once complete, based on the responses provided, the respondent was automatically assigned an antibiotic that best matched their personality. This result was accompanied by key teaching points about the assigned antibiotic, a statement about the importance of appropriate antibiotic use and links to find more information. The quiz was launched in November 2017 to coincide with World Antibiotic Awareness Week and disseminated via social media. It was updated iteratively each year. We evaluated usage statistics from November 7 2017 to June 7 2020. Results During the 31-month evaluation period, there were 287,868 views of the quiz, and it was completed 207,148 times. The quiz was shared extensively on social media (Facebook 1667 shares, Twitter 1390 clicks). From a subset of 37,825 recent participants who were asked about their profession, most identified as non-infectious diseases healthcare professionals (n= 18,235, 48.2%), followed by infectious disease healthcare professionals (n=8,119, 21.8%), and healthcare students (n=6,986, 18.5%) (Figure 1). Respondents were well-represented globally, including US, Canada, Spain, France, India, United Kingdom, and Indonesia. Conclusion This exploratory analysis suggests incorporation of play into social media campaigns may augment the size of the receiving audience. An antibiotic awareness personality quiz engaged a high volume and broad range of non-infectious disease experts in learning more about antibiotic resistance. Antimicrobial stewards and public health campaign leaders should incorporate play into awareness opportunities and evaluate their impact. Disclosures All Authors: No reported disclosures

AbstractObjectives: Cognitive reserve moderates the effects of gray matter (GM) atrophy on cognitive function in neurological disease. Broadly speaking, Reserve explains how persons maintain function in the face of cerebral injury in cognitive and other functional domains (e.g., physical, social). Personality, as operationalized by the Five Factor Model (FFM), is also implicated as a moderator of this relationship. It is conceivable that these protective mechanisms are related. Prior studies suggest links between Reserve and personality, but the degree to which these constructs overlap and buffer the clinical effects of neuropathology is unclear. Methods: We evaluated Reserve and FFM traits—Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness—in a cohort of 67 multiple sclerosis (MS) patients. We also examined the extent to which FFM traits and aspects of Reserve interact in predicting cognitive processing speed. Results: Retrospectively reported educational/occupational achievement was associated with higher Openness, and childhood social engagement was associated with higher Extraversion, Agreeableness, and Conscientiousness. Current involvement in exercise activities and social activities was associated with Extraversion, current involvement in hobbies was associated with Neuroticism, and current receptive behaviors were associated with Agreeableness and Conscientiousness. When tested as predictors, Conscientiousness and childhood enrichment activities interacted in predicting cognitive processing speed after accounting for age, disease duration, disability, and GM volume. Conclusions: Childhood enrichment activities and Conscientiousness have a synergistic effect on cognitive processing speed. Current findings have implications for using psychological interventions to foster both Reserve and adaptive personality characteristics to stave off clinical symptoms in MS. (JINS, 2016, 22, 920–927)

Exploring the disruptions to intrinsic resting-state networks (RSNs) in schizophrenia-spectrum disorders yields a better understanding of the disease-specific pathophysiology. However, our knowledge of the neurobiological underpinnings of schizotypal personality disorders mostly relies on research on schizotypy or schizophrenia. This study aimed to investigate the RSN abnormalities of schizotypal personality disorder (SPD) and their clinical implications. Using resting-state data, the intra- and inter-network of the higher-order functional networks (default mode network, DMN; frontoparietal network, FPN; dorsal attention network, DAN; salience network, SN) were explored in 22 medication-free, community-dwelling, non-help seeking individuals diagnosed with SPD and 30 control individuals. Consequently, while there were no group differences in intra-network functional connectivity across DMN, FPN, DAN, and SN, the SPD participants exhibited attenuated anticorrelation between the right frontal eye field region of the DAN and the right posterior parietal cortex region of the FPN. The decreases in anticorrelation were correlated with increased cognitive–perceptual deficits and disorganization factors of the schizotypal personality questionnaire, as well as reduced independence–performance of the social functioning scale for all participants together. This study, which links SPD pathology and social functioning deficits, is the first evidence of impaired large-scale intrinsic brain networks in SPD.

Background.Osteopathic philosophy and practice are congruent with the biopsychosocial model, a patient-centered approach when treating disease, and the view of the person as a unity (i.e., body, mind, and soul). Nevertheless, a unity of being should involve a systematic person-centered understanding of the patient’s personality as a biopsychosociospiritual construct that influences health (i.e., well-being and ill-being). We suggest Cloninger’s personality model, comprising temperament (i.e., body) and character (i.e., mind and soul), as a genuine paradigm for implementation in osteopathic practice. As a first step, we investigated (1) the relationships between personality and health among osteopathic patients, (2) differences in personality between patients and a control group, and (3) differences in health within patients depending on the presenting problem and gender.Method.524 osteopathic patients in Sweden (age mean = 46.17,SD= 12.54, 388 females and 136 males) responded to an online survey comprising the Temperament and Character Inventory and measures of health (well-being: life satisfaction, positive affect, harmony in life, energy, and resilience; ill-being: negative affect, anxiety, depression, stress, and dysfunction and suffering associated to the presenting problem). We conducted two structural equation models to investigate the association personality-health; graphically compared the patients’ personalityT-scoresto those of the control group and compared the mean raw scores usingt-tests; and conducted two multivariate analyses of variance, using age as covariate, to compare patients’ health in relation to their presenting problem and gender.Results.The patients’ personality explained the variance of all of the well-being (R2between .19 and .54) and four of the ill-being (R2between .05 and .43) measures. Importantly, self-transcendence, the spiritual aspect of personality, was associated to high levels of positive emotions and resilience. Osteopathic patients, compared to controls, scored higher in six of the seven personality dimensions. These differences were, however, not considerably large (divergences inT-scoreswere <1SD,Cohen’s dbetween 0.12 and 0.40). Presenting problem and gender did not have an effect on any of the health measures.Conclusion.The patient’s personality as a ternary construct (i.e., body, mind, and soul), which is in line with osteopathy, is associated to both well-being and ill-being. The lack of substantial differences in personality between patients and controls implies that the patients had not any personality disorders. Hence, osteopaths might, with proper education, be able to coach their patients to self-awareness. The lack of differences in health variables between osteopathic patients with different presenting problems suggests that practitioners should focus on the person’s health regardless of the type of presenting problem.

Coronavirus disease 19 (COVID-19) has had a strong psychological impact on the Italian population. Italy was heavily affected by the virus before other countries in Europe, experiencing the highest number of deaths. Unknown symptoms in the early stages of the pandemic and the absence of clear transmission links affected people’s wellbeing. Individual personality differences played a key role in perceived psychological wellbeing during the pandemic. The present exploratory study sought to evaluate the impact of COVID-19 on psychological health and identify how psychological wellbeing is influenced by personality traits. A total of 2103 participants (64% female and 36% male) completed an online survey that included the Psychological General Wellbeing Index (PGWBI), the Italian Short Personality Inventory (ITAPI), and a general questionnaire. Descriptive statistics and hierarchical regressions were performed using SPSS 25.0 (IBM Corp., Armonk, NY, USA) (The findings showed poor psychological wellbeing in the Italian population. Young people reported the lowest scores. Vulnerability traits negatively influenced some PGWBI domains, such as the total score (β = −0.62), anxiety (β = −0.55), depression (β = −0.46), positivity and wellbeing (β = −0.51), vitality (β = −0.45), general health (β = −0.12), and self-control (β = −0.52). On the other hand, dynamism traits positively affected vitality (β = 0.12) and positivity and wellbeing (β = 0.14). In other words, personality factors related to vulnerability in particular created risk, whereas dynamism offered protection. The results highlight how COVID-19 helped to trigger anxious and depressive states. People feel helpless and vulnerable when facing new, unexpected conditions caused by the virus. These findings may assist mental healthcare professionals in safeguarding psychological wellbeing during emergencies such as the pandemic.

The article examines the personal characteristics of patients with diseases of the cardiovascular system (ischemic heart disease and hypertensive heart disease) in connection with the formation of adherence to treatment. The study identified personal factors interrelated with various aspects of adherence, which are considered in line with the author's approach (awareness, medical trust, health-preserving behavior). Thus, the personality factors that favor the effective awareness of the patient about the lifestyle and therapy are high self-control, sensitivity, flexibility and social courage, while dominance acts as a psychological barrier in this regard. The formation of trust is positively associated with a high standard of behavior, diplomacy and self-control, and negatively with non-conformism. The behavioral aspect of adherence is determined by emotional stability, low anxiety and, in part, intelligence. At the same time, expressiveness and independence have a negative relationship with this component. Differences were found in the mean values on the adherence scale in men and women, as well as in samples of patients with different nosologies. The hypothesis of differences in the distribution of types of attitudes towards the disease in patients with hypertension and coronary heart disease was confirmed.

Evolutionary psychologists propose that humans evolved a first line of defense against pathogens: the behavioral immune system (BIS). The BIS is thought to be functionally flexible such that the likelihood and magnitude of BIS activation depends on the individual’s perceived vulnerability to disease (PVD). Because conspecifics are sources of infection, the BIS has implications for affiliation. By priming and measuring chronic levels of PVD, we examined PVD’s relation to affiliation in zero-acquaintance situations in the laboratory, online, and during speed-dating events. Elevated BIS activation was associated with decreased attraction and affiliative behavior in situations that varied in the trade-off between social reward and potential risk of infection. These results were not due to attachment style, personality traits, or disgust sensitivity. This suggests that in social interactions, approach motivation associated with the need to belong may be weighed against avoidance motivation associated with the need to protect the self from disease.

The investigation of personality traits of patients suffering from migraine headache with the Minnesota Multiphasic Personality Inventory (MMPI) is an important line of research, and differentiating syndromes in treating this disease is one of the characteristics of Chinese Medicine (CM). This study presents the MMPI-(Chinese edition) responses of 80 Chinese subjects with migraine and 40 non-headache healthy control subjects. Among them, migraine fire syndrome (MF) group consisted of 45 subjects (10 men, 35 women); migraine Qi stasis syndrome (MQ) group, 35 subjects (8 men, 27 women). The healthy control group was divided into healthy Qi stasis syndrome (HQ) group, 9 subjects (2 men, 7 women); and healthy normal (HN) group, 31 subjects (7 men, 24 women) according to CM diagnostic criteria. Statistical analysis was performed by pairs among four groups. The results revealed that both MF and MQ groups' MMPI profiles were significantly higher than that of the Normal (HN) group, and formed a 1.2.3.7 type slope. Profile deviation in the MQ group was slight, but in the MF group was serious and accompanied by a significant rising scores in F, paranoia (6), schizophrenia (8) and social introversion (0) subtests; HQ group's MMPI profile had a similar deviation as in the MQ group. The results suggest that CM migraine syndromes have an exact expression on MMPI profile, and that MMPI as an effective diagnostic method could be applied for CM syndrome discrimination. The "deviation of migraineurs' personality" may not be a special characteristic held only by migraineurs. The existence of different syndromes in migraine is one of the reasons that different scholars have reported different results on migraine by means of MMPI.

AbstractThis article captures the webinar narrative on March 31, 2020 of four expert panelists addressing three questions on the current coronavirus disease 2019 (COVID-19) pandemic. Each panelist was selected for their unique personal expertise, ranging from front-line emergency physicians from multiple countries, an international media personality, former director of the US Strategic National Stockpile, and one of the foremost international experts in disaster medicine and public policy. The forum was moderated by one of the most widely recognized disaster medical experts in the world. The four panelists were asked three questions regarding the current pandemic as follows:1.What do you see as a particular issue of concern during the current pandemic?2.What do you see as a particular strength during the current pandemic?3.If you could change one thing about the way that the pandemic response is occurring, what would you change?

Purpose: analysis of the literature on the influence of socio-psychological factors on the complimentary behavior of patients with schizophrenia. Material: according to the keywords “schizophrenia”, “compliance”, “adherence to treatment”, “awareness of the disease”, “psychological factors”, “social factors”, “psycho-education”, “family therapy”, articles of domestic and foreign authors were selected and studied, devoted to the problem of compliance with schizophrenia patients and published in the last two decades. To compile a literature review, articles in the MedLine/PubMed, eLIBRARY, databases were selected and analyzed, relevant links in the literature lists of the analyzed articles. Discussion: analysis of publications showed that at present, numerous factors have been identified that affect the compliant behavior of schizophrenia patients, among which factors associated with the clinical picture of the disease, cultural and religious characteristics of individuals, medication, the organization of medical care, and many others have been identified. The article most thoroughly discusses the socio-psychological factors of schizophrenia patients’ compliance — the internal picture of the disease, the emotional response of the patient and his relatives to the disease, the therapeutic alliance with specialists of the psychiatric service and a number of other factors. The relationship of the schizophrenia patients’ compliance with their cognitive, emotional and motivational-behavioral spheres of personality was considered. Conclusion: compliance of patients with schizophrenia can improve the combination of drug therapy with psychoeducational work. A psychoeducation program should be available to most of them. Given the influence of relatives on the formation of compliance with schizophrenia patients, it is necessary to include family therapy in treatment and rehabilitation programs of psychiatric institutions.

Many animals socialize in two or more major ecological contexts. In nature, these contexts often involve one situation in which space is more constrained (e.g. shared refuges, sleeping cliffs, nests, dens or burrows) and another situation in which animal movements are relatively free (e.g. in open spaces lacking architectural constraints). Although it is widely recognized that an individual's characteristics may shape its social life, the extent to which architecture constrains social decisions within and between habitats remains poorly understood. Here we developed a novel, automated-monitoring system to study the effects of personality, life-history stage and sex on the social network structure of a facultatively social mammal, the California ground squirrel ( Otospermophilus beecheyi ) in two distinct contexts: aboveground where space is relatively open and belowground where it is relatively constrained by burrow architecture. Aboveground networks reflected affiliative social interactions whereas belowground networks reflected burrow associations. Network structure in one context (belowground), along with preferential juvenile–adult associations, predicted structure in a second context (aboveground). Network positions of individuals were generally consistent across years (within contexts) and between ecological contexts (within years), suggesting that individual personalities and behavioural syndromes, respectively, contribute to the social network structure of these free-living mammals. Direct ties (strength) tended to be stronger in belowground networks whereas more indirect paths (betweenness centrality) flowed through individuals in aboveground networks. Belowground, females fostered significantly more indirect paths than did males. Our findings have important potential implications for disease and information transmission, offering new insights into the multiple factors contributing to social structures across ecological contexts. This article is part of the theme issue ‘Interdisciplinary approaches for uncovering the impacts of architecture on collective behaviour’.

Tenofovir is widely used as first-line treatment of HIV infection, although its use is sometimes complicated by a reversible proximal renal tubulopathy. We report the case of a 45-year-old woman with chronic HIV infection and personality disorder, who after 12 months of tenofovir, complained of fatigue, diffuse bone pain and gait disturbances. The elevated level of alkaline phosphatase, hypophosphatemia and inappropriate phosphaturia suggested the diagnosis of hypophosphatemic osteomalacia secondary to proximal renal tubulopathy. A dual-energy x-ray absorptiometry showed a bone mineral density below the expected range for age (lumbar spine Z-score -3.3, femoral neck Z-score -2.1). A whole body 99mTc-methylene diphosphonate bone scan showed multiple areas of increased focal activity in the lumbar and thoracic spine and in sacroiliac and hip joints consistent with pseudo-fractures. Two months after tenofovir discontinuation and administration of vitamin D and phosphate, osteomalacia-related symptoms disappeared. Eleven months later, bone and mineral metabolism data were normal and bone scintigraphy did not show any pathological findings. This report highlights the importance of considering the diagnosis of osteomalacia in patients treated with tenofovir and emphasizes the need for monitoring alkaline phosphatase, blood and urinary phosphate and creatinine, especially in patients with risk factors for bone disease.

Poverty in Indonesia is still one of the social problems. Central Bureau of Statistics (BPS) noted, as of March 2017 the number of poor people, namely residents with per capita expenditure per month below the poverty line) in lndonesia reached 27.77 million people (10.64 percent of the total population). As quoted by the Head of BPS, that number increased 6.90 thousand people compared to September 2016 which amounted to 27.76 million people (10.70 percent). Although the percentage of poverty rates has decreased, in total the number has increased. Women's empowerment is an effective way to eliminate poverty, hunger, and disease and to support sustainable development. Some things must be considered in order shaping the model of empowering poor women is: the empowerment stage is preceded with the formation of empowerment models that are arranged systematically and scientifically, with combining theoretical aspects of empowerment, needs in the field, consultation with relevant agencies, literature review, as well as input from empowerment and gender experts, the existence of cooperatives was formed after the production system ran smoothly. Establishment of this cooperative need to be supported by motivating the consultant. High potential in undergoing an entrepreneurial profession or possessing high potential as a prospective entrepreneur or entrepreneur. Entrepreneurship training for Poor women in using the Project Based Learning model are considered effective because most participants are successful in terms of the level of mastery of personality (soul) entrepreneurship and skills possessed while gaining learning experience real business.

Traditionally depression was defined as a mental illness. Acknowledgment of biopsychosocial model in modern medicine brought about a number of interdisciplinary studies. In the meantime, a number of correlations in the onset, cause and prognosis between depression and other somatic as well as mental illnesses were discovered. The research results showed that from one hand, depression could be an independent factor of the possible development of heart infarct, on the other hand it can influence the recovery process in cardiological patients. The conducted studies established some common pathways in depression and vascular diseases development. Psychoneuroimmunological research gives the data about the influence of anxiety and depression on the interleukine profile that could be a matter of further investigation of the possible links between depression and cancer diseases. The other dimension is the addiction impact on depression onset. The interrelationship between epilepsy as organic brain disease and depression is also worth of attentional. Hypercortisolemia and low-grade inflammation plays an important role both in depression and dementia. There is also a strong correlation between personality traits and depression itself and as response to unfavorable circumstances and somatic illness as well. We propose to apply to depression the principles of pathological stable circuits with the self-sustained reverbation engram chains mechanisms. All these data calls for consideration of depression as an interdisciplinary phenomena.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Abstract Higher scores on the personality trait of neuroticism, the tendency to experience negative emotions, are associated with worse mental and physical health. Studies examining links between neuroticism and health typically operationalize neuroticism by summing the items from a neuroticism scale. However, neuroticism is made up of multiple heterogeneous facets, each contributing to the effect of neuroticism as a whole. A recent study showed that a 12-item neuroticism scale described one broad trait of general neuroticism and two special factors, one characterizing the extent to which people worry and feel vulnerable, and the other characterizing the extent to which people are anxious and tense. This study also found that, although individuals who were higher on general neuroticism lived shorter lives, individuals whose neuroticism was characterized by worry and vulnerability lived longer lives. Here, we examine the genetic contributions to the two special factors of neuroticism—anxiety/tension and worry/vulnerability—and how they contrast with that of general neuroticism. First, we show that, whereas the polygenic load for neuroticism is associated with the genetic risk of coronary artery disease, lower intelligence, lower socioeconomic status (SES), and poorer self-rated health, the genetic variants associated with high levels of anxiety/tension, and high levels of worry/vulnerability are associated with genetic variants linked to higher SES, higher intelligence, better self-rated health, and longer life. Second, we identify genetic variants that are uniquely associated with these protective aspects of neuroticism. Finally, we show that different neurological pathways are linked to each of these neuroticism phenotypes.

Background and Objectives:Body Dysmorphic Disorder (BDD) is characterized by an abnormal preoccupation with alleged misshapen body parts. There is often poor insight and effort is made to hide the imagined defects, and consultation may be sought seeking unnecessary cosmetic surgery or procedures. It is underdiagnosed and established treatment protocols are lacking. The disease has a chronic and undulating course and is seriously compromises quality of life. Despite the fact that the prime age of onset of BDD is during adolescence relatively little has been written about it during this phase of life. This review aims to comprehensively cover the present understanding of BDD, including clinical features, epidemiology, psychopathology, nomenclature, comorbidity and management.Methods:A literature search was undertaken using suitable key words on Google Scholar, MEDLINE & PsychoINFO up to June 2018 limited to articles in English.Results:he prevalence of BDD is variable in the general and psychiatric population with equal gender distribution. Both sexes are equally affected. It is associated with poor functioning and a chronic course. There is considerable comorbidity and diagnostic overlap between BDD and obsessive-compulsive disorder, major depressive disorder, social anxiety disorder, anorexia nervosa, schizophrenia spectrum disorders and personality disorders. Psychiatric consultation is often late. Selective Serotonin Reuptake Inhibitors (SSRIs) and Cognitive Behavior Therapy (CBT) are currently the first line modalities for treatment. Internet based CBT, Acceptance and commitment therapy, and repetitive Transcranial Magnetic Stimulation (rTMS) are emerging treatment options.Conclusions:BDD is a complex disorder with still lot of uncertainty about its diagnostic placement, treatment approaches, especially for refractory patients, and prognosis. Further study is needed to clarify its prevalence, especially in adolescents; to fully understand its neurobiological aspects, to determine its exact relation to obsessive compulsive related disorders, and to develop better treatment approaches.

Introduction Health is the greatest value in our lives. Analyzing the current approaches of the WHO (2014), we consider this concept not only from the standpoint of physical health and the absence of disease, but understand this phenomenon as a holistic state of complete well-being, which includes, in addition to physical, emotional, mental, social, spiritual, sexual, environmental and many other aspects. This is the so-called holistic model of health (Orzhekhovska, 2013). Our reasoning suggests (given various aspects of health) that this value does not depend only on an individual's choice to be or not to be healthy, and cannot be governed solely by personal actions. Here are some examples. The lack of geographically close medical services and / or free medical services causes the inability to receive emergency medical care and / or to systematically monitor health. Negative relationships in the family, the absence of a father or mother in the family can lead to emotional rejection of the child (psycho-emotional disorders), the acquisition of undesirable behavior (child addictive behavior or delinquent behavior), lack of self-care skills (this can cause various infectious diseases), getting into institutional care, which usually do not contribute to the full development of personality, etc. Inadequate social policies and an imperfect health care system in the country can cause outbreaks of socially dangerous diseases and provoke the spread of pandemics. Aggressive urbanization creates uncomfortable living conditions in cities due to traffic jams, pollution, noise, which causes other health risks from stress to cancer. As we can see, good health depends not only on the individual being healthy in the broad context of this word, but on the complex impact on us of a number of systems in which we are included. It is important to emphasize the role of social work in this context, the theory and practice of which aim, inter alia, to promote social development and well-being, as well as to improve the health care system and reduce social inequalities. Therefore, the task of social work in general and social workers together with other professionals in particular is to support the individual, family, community, society in the context of strengthening and maintaining the health of both individual and public. An ecosystem approach in social work helps us to understand the process of maintaining and strengthening health, which explains well the mutual influence of each element of the system. Purpose The aim of the article was to consider health social work according to ecosystem approach. Methodology The study used theoretical methods of research, in particular, analysis, comparison, synthesis and implementation of the results of the study of health social work based on the principles of integral ecology and ecosystem approach. Results and Discussion The ecosystem approach is used in various spheres of practical and scientific activity: public health, ecology, economy, legal and social spheres, church-religious sphere and even education (Forget, Lebel, 2001; Deinega, 2018; Veklych, 2017; Voronkin, 2017). Kabanenko and T. Semigina (2004) write about the separation of the ecological approach in social work on the basis of systems theory (sociological group of social work theories). Within this approach, the authors consider the main models of work and tools that can be used by social workers in their practice: eco-maps, genograms, etc. Systems theory and environmental theory are mentioned in the manual "Introduction to Practical Social Work". In systems theory, "a whole is greater than the sum of its parts", so it is important to consider "the interaction of the client and the environment." Ecological theory considers a person in the context of his or her entourage, but not only the family, society, but also the environment (Klos, Mykytenko, 2005, 52-54). In contrast to the mentioned researchers, T. Syla (2012) explores the problem of violence in the context of the ecosystem approach, she notes that this approach originates from the socio-ecological theory of Bronfenbrenner in psychology. So, no matter what theories the ecosystem approach is based on, the idea behind this concept is a wide range of interconnections. Every smaller object, such as a person, is part of a large range of interactions of larger systems: family, community, society, environment, and so on. Each element of the system affects the other, so solving a problem situation in one area can be an impetus for positive change in another. Chaikovska and O. Hlavatska talk about the need to train social workers with a "high level of environmental culture" (2019). In scientific works on social work we find the concepts "ecosystem approach" and "ecological approach", which are virtually identical in content. This perspective has formed over time one of the modern concepts of social work: "environmental social work", or "eco-social work", or "green social work". The latter in her current research is much covered by T. Semigina (2018). The researcher notes that "a healthy environment is seen as an inalienable human right, a component of human dignity and non-discrimination." However, today there is no research on health social work from the standpoint of an ecosystem approach. The ecosystem approach resonates with another very important concept. It is an integrated ecology. This concept appeared in the church-religious sphere, and was covered in the Encyclical (papal document) "Laudato si" by the head of the Catholic Church Pope Francis (2015/2019). According to the vision of Francis, there can be no question of ensuring the common good, guaranteeing fundamental rights, social justice, if humanity understands nature as something separate and does not link environmental pollution with economic activity, behavior, etc. Conclusion Therefore, it is obvious that today, in the conditions of social transformations and globalization processes, the solution of any social problem should be considered from the standpoint of the ecosystem approach. Health issues in social work cannot be considered without taking into account changes in the environment. For such activities, it is necessary to train social workers in the context of the ecosystem approach, programs and projects should be developed to help overcome the problems of clients' health in a comprehensive way. Further research is needed to study existing and develop new forms and models of social work on the basis of strengthening and maintaining the health of clients, taking into account the ecosystem approach and the basics of integral ecology

Background. In modern conditions there is a quick increase in non-chemical addictions, primarily computer addiction. Unfortunately, patients with non-chemical addictions do not fall into the field of view of doctors at the early stages of the development of the disease. They seek specialized help when addiction becomes a chronic process; due to disability, and delinquent behavior, which contributes to a violation of social functioning and quality of life of the patient and his family. Objective – to develop and evaluate the effectiveness of a comprehensive program for the treatment of adaptation disorders associated with computer addiction, based on the study of clinical, psychopathological and pathopsychological patterns of their formation. Materials and methods. The study involved 117 patients with signs of computer addiction according to the results of AUDIT-like tests and with adaptation disorders. The main group consisted of 66 patients who took part in the complex therapy program using the methods of pharmacotherapy, psychotherapy and psycho-education; control group – 51 patients who received standard regulated therapy in a medical institution. We used such study methods: clinical-anamnestic; clinical-psychopathological, using AUDIT-like tests for a comprehensive assessment of addictive status, psychodiagnostic using a hospital scale of anxiety and depression, Hamilton anxiety rating scale, Hamilton depression rating scale, the questionnaire of neuro-psychic tension according to T. A. Niemchyn; statistical. Results. The clinical picture of computer addiction noted: compulsive surfing in a computer network (45.8±1.6% of the examined), computer games (22.3±1.2%), virtual communication (5.8±0.4%), gambling on-line (14.1±1.1%), passion for porn sites (1.2±0.1%). All examined patients received pharmacotherapy – antidepressants (SSRI) and anxiolytic drugs. and anxiolytic drugs. The psychotherapeutic complex included the use of rational psychotherapy, personality-oriented psychotherapy, existential psychotherapy, art therapy (painting technique). Psycho-educational work included the use of information modules, motivational trainings, the formation of communicative skills, problem-oriented discussions and teaching coping skills. Psychotherapeutic and psycho-educational work was aimed at determining the patient’s resource in overcoming computer addiction and its occurrence. Due to effects of the developed comprehensive program for the treatment of adaptation disorders associated with computer addiction, positive dynamics of the emotional status of patients were achieved, reduction of manifestations of anxiety and depression by HADS, reduction of manifestations of severe depressive and anxious episodes according to the Hamilton scales as well as reduce neuropsychic stress on a scale of T. A. Niemchyn were indicated. Conclusions. A comprehensive system for the treatment of adaptation disorders associated with computer addiction should include a combination of pharmacotherapy, psychotherapy and psycho-education. Positive dynamics of the emotional status of patients, the predominance of subclinical manifestations or the absence of anxiety and depression on the HADS scale; mild depressive and anxious episodes or their absence according to the HAM-D and HAM-A scales; reduction of neuropsychic stress on a scale of T. A. Niemchyn as well as stability of the therapeutic effect during a two-year follow-up study indicates the effectiveness of the developed comprehensive therapy program.

List of abstracts and authors:1. Comparative benefits of Atypical antipsychoticsDiana P Morrison2. Evidence-based management of depression in SchizophreniaAndre F Joubert3. Second generation Antipsychotics: An African updateDave Swingler4. The drug management of patients with HIV/Aids in the Mental Health Care setting: A therapeutic challengeDenise White5. New developments in the treatment of Bipolar depressionJospeh R Calabrese6. Dual action antidepressants: Faster onset, more remission, better value?Roger M Pinder7. Antisocial personality disorder: A reviewDonald W Black8. The South African study of stress and health: An overviewDavid R Williams9. Ugliness is in the eye of the beholder: Psychiatric apsects of body image disturbanceDavid Castle10. Over diagnosed or under recognized? Treating ADHDDora Wynchank11. The contagious effects of trauma and their impact on human service organisationsKerry Gibson12. Temporal lobe epilepsy in adolescence - 'Understanding the narrative'Helen Clark13. The effectiveness of treatment programs for Methaqualone (Mandrax) dependenceGreg McCarthy, Nandi Siegfried, Bronwyn Myers14. Community influence on alcohol and marijuanaAlan J Flisher, Robyn Mallett, Gary King, Neo Morojele, Martie Muller, Carl Lombard15. Psychiatric presentations of medical illnessSebastian Akalula16. Imaging of brain function using SpectJames Warwick17. Selected neuropsychological test performances and SSRI usageTheophilus Lazarus18. Comparative effectiveness and safety of antipsychotic treatments for outpatient SchizophreniaFrans Korb, Adel Sadak, Aly Akram, Sunar Birsoz, Abderrahmane Belaid19. Evidence-based mental healthcare - What do you know, think, feel?Nandi Siegfried, George Swingler, Soraya Seedat, Martie Muller, Rachel Churchill, Dan Stein20. Competitions Act - Anti-competitive health care practicesZ Nthakwana21. Unique approach to mental wellness by medical SchemesPetro Kempen22. What happens to my medical aid contribution?Eugene Allers23. Financial issues in a modern private practiceMike Edwards24. Transcranial magnetic stimulation: Uses in brain function research and medical interventionAlan St Clair Gibson25. The Neurochemistry of dreams: Implications for PsychiatryMark Solms26. Tenascin-R expression in the Central Nervvous system of lower vertebratesRuth Jarvis, N-. Hsu, P. Pesheva and D.M. Lang25. Localisation of the Nogo-A receptor in Neronal Lipid raftsEdward Nyatia, D.M. Lang26. Characterising an animal model for early life trauma using time dependent sensitisationJoachim D.K. Uys, Willie M.U. Daniels, Dan J. Stein27. Tolmetin affords protection against Quinoclinic acid induced Neurotoxixity in Rat brainAmichand Dairam, S Daya28. Acetaminophen and aspirin inhibit superoxide anion generation and Lipid Peroxidation, and protect against 1-Methyl-4Phenyl Pyridinim-induced Dopaminergic Neurotoxicity in ratsH. Maharaj, D.S. Maharaj, K. S. Saravanan, K.P. Mohanakumar, S. Daya29. Can exercise provide Neuroprotection in a rat model for Parkinson's disease?M Mabandla, L Kellaway, A St Clair Gibson, M Lambert, V Russell30. Treatment of rapid cycling Bipolar disorderJoseph R. Calabrese31. Depression as a Neurodegenerative Disorder: The need for achieving remissionRoger M Pinder32. Side-effects induced by modern antidepressants- Overview and managementFranco Colin33. The Placebo response in antidepressant clinical trialsRobin Emsley34. Impulse control disorders: An overviewDonald W. Black35. Post traumatic stress disorder: The Wits trauma clinic experienceUgash Subramaney36. Post traumatic stress disorder among recently diagnosed patients with HIV in South AfricaSoraya Seedat, Bo Olley, D J Stein37. Improving outcome in SchizophreniaDiana P Morrison38. Reviewing post Graduate trainingCliff W Allwood39. Ethics in HIV ResearchKeimanthro Moodley40. Improving and maintaining ethical standrads in Psychiatric researchTuviah Zabow=============================================================Posters: Neurosciences section (Presenting author only)1. Blunted Acth response correlates with altered Neurotransmitter function in maternally separatedratsW M U Daniels2. A mechanism for zinc toxicity in Neuroblastoma cellsW M U Daniels3. The effects of Hypericum Perforatum, Quercetin, and Fluoxetine on receptor densities in the Rat BrainL Heiderman4. Trichotillomania and obsessive-compulsive disorder: Clinical and genetic comparisons within a South African populationS M J Hemmings5. Expression of Nogo-A in the amphibian central nervous systemN. J. Hsu6. Biochemical model for inflammation of the brain: The role of iron, transferring and toxiferring in Lipid PeroxidationS J Van Rensburg7. Improvement in Alzheimer's disease patients with antioxidant supplementation over 15 monthsS J Van Rensburg8. The Placebo effect - Is it all in the mind?S J Van Rensburg9. Very low serum iron concentrations in elderly patients with active CarcinomaS J van Rensburg10. Melatonin affords protection against Rotenone-induced NeurotoxicityR John11. Effect of enriched environment on Ca uptake via NMDA receptors into barrel cortex slices of spontaneously HypertensiveratsM Lehohla12. Effects of Methylpenidate in a rat model for Attention Deficit Hyperactivity DisorderG. L. S. Lelaka13. 6-Hydroxymelatonin converts Fe (III) to Fe(II) and reduces iron-induced Lipid PeroxidationD S Maharaj14. Metrofinate Potentiates Quinolinic Acid and Potassium Cyanide induced NeurotoxicityA Ramsunder15. The effect of chronic Intra-Amylgdala CRF injections on rat behaviour and HPA-Axis functionL Richter16. Effect of Glutamate in the Prefrontal Cortex of a rat model for Attention-Deficit Hyperactivity DisorderV Russell17. An investigation into the relationship between Corticosterone and Neuron Cell deathP J Van Vuuren=============================================================41. Blunted Acth response correlates with altered Neurotransmitter function in maternally separated RatsW M U Daniels, C Y Pietersen, M E Carstens, D J Stein42. A mechanism for Zinc Toxicity in NeuroBlastoma CellsW M U Daniels, J Hendricks, R Salie, S J Van Rensburg43. The effects of Hypericum Perforatum, Quercetin and Fluoxetine on receptor densities in the rat brainL Heideman and S Daya44. Trichotillomania and obsessive-compulsive disorder: Clinical and genetic comparisons withn a South African populationS M J Hemmings, C J Kinnear, C Lochner, H Moolman-Smook, D J H Niehaus, V Corfield, D J Stein45. Expression of Nogo-A in the amphibian central nervous systemN. J. Hsu, R Jarvis, D. M. Lang46. Biochemical model for inflammation of the brain: The role of iron, transferring and Toxiferring in Lipid PeroxidationS J Van Rensburg, R T Erasmus, J M van Zyl, D Hon, W M U Daniels, F C V Potocnik, M J Kotze, N J De Villiers, P R Hurly47. Improvement in Alzheimer's Disease patients with antioxidant supplementation over 15 monthsS J van Rensburg, F C V Potocnik, J M Van Zyl, B J Van der Walt, D Hon, A Roos, E Rienhardt, R T Erasmus48. The Placebo effect - Is it all in the mind?S J van Rensburg, R A Emsley, C M Smuts, M Kidd, S Van der Merwe, C C Myburgh, P Oosthuizen, H Bleeker49. Very low serum Iron concentrations in elderly patients with active CarcinomaS J van Rensburg, R Erasmus, D Hon, C Bouwens50. Melatonin affords protection against Rotenone-induced NeurotoxicityR John, S Daya51. Effect of enriched environment on Ca uptake via NMDA Receptors into barrel Cortex slices of spontaneously Hypertensive ratsM Lehohla, V Russell, L Kellaway52. Effects of Methylpenidate in a rat model for Attention-Deficit Hyperactivity DisorderG. L. S. Lelaka, V. A. Russel, L. A. Kellaway53. 6-Hydroxymelatonin converts Fe (III) to Fe (II) and reduces iron-induced Lipid PeroxidationD S Maharaj, S Daya54. Metrofinate Potentiates Quinolinic Acid and Potassium Cyanide induced NeurotoxicityA Ramsunder, S Daya55. The effect of chronic Intra-Amygdala CRF injections on rat behaviour and HPA-Axis functionL Richter, W Daniels, D J Stein56. Effect of Glutamate in the Prefrontal Cortex of a rat model for Attention-Deficit Hyperactivity DisorderV Russell, M Lehohla, L Kellaway57. An investigation into the relationship between Corticosterone and Neuron cell deathP J Van Vuuren, J Hendricks, W M U Daniels=============================================================Posters: Psychiatry Section1. Descriptive study of Tardive Dyskinesia in a South African Xhosa populationS Brink2. Alcohol drinking problems at three urban High Schools in UmtataO Alonso Betancourt3. Childhood and adolescent sexual abuse - Demographic, traumatic and clinical signpostsP D Carey4. Inositol in the treatment of Obsessive Compulsive DisorderP D Carey5. A review of factors associated with Suicidal behaviour in children and adolescents admitted to Tygerberg HospitalT Du Plessis6. Psychological and physical outcomes fo elective abortion; Local Anaesthesia vs Intravenous SedationT Ericksen7. Mental health literacy of Human Resource Practitioners in South AfricaC J Hugo8. The importance of a specialized clinic for the care of patients with first episodes of psychosisN Keyter9. Self-report vs Urinary drug screening in Schizophrenia: A pilot studyL Koen10. The effect of aggression on the use of Psychotropics in Schizophrenia: A naturalistic studyH Lategan11. Factor analysis of obsessive-compulsive spectrum disorders in patients with obssessive-compulsive disorder: Clinical and Genetic correlatesC Lochner12. Experiences in obsessive-compulsive Disorder and Trichotillomania: Role of childhood traumaC Lochner13. Delusional systems in Xhosa Schizophrenia SibpairsJ E Muller14. OCD Heteogeneity reflected by lack of Genealogically determined founder effectD J H Niehaus15. The efficacy and tolerbaility of low-dose vs standard dose Haloperidol in first episode Psychosis. A randomised, double-blind studyP P Oosthuizen16. Treatment with low-dose Haloperidol does not protect against Tardive DyskinesiaP P Oosthuizen17. Do healthcare funders discriminate against members on the grounds of mental illness?O Scholtz18. Treatment strategies in patients with Clozaopine-resistant Schizophrenia at Stikland Hospital: A critical evaluation of one optionA Schulte19. Early coadministration of Clonazepam with Paroxetine for generalized social anxiety disorderS Seedat20. Trauma exposure and post-traumatic stress symptoms in adolescents: A schools' survey in Cape Town (South Africa) and Nairobi (Kenya)S Seedat21. The QTC effects of Thioridazine when used as a second line Anti-psychotic ( at Stikland Hospital)C Seller22. Brain imaging and substance related disordersD J Stein23. Gender differences in trauma exposure & post traumatic stress disorder in a clinic sampleS Suliman24. Assessing the prevalence of anxiety and depressive symptoms among clinica at Tygerbeg Academic Hospital and controlsH Van der Bijl25. Pharmacological challenge with a serotonin ID Agonist in alcohol dependenceB Vythilingum26. The treatment of ADHD in adultsW Verbeeck=============================================================58. Descriptive study of Tardive Dyskinesia in a South African Xhosa populationS Brink, D J H Niehaus, L Koen, J E Muller59. Alcohol drinking problems at three Urban High Schools in UmtataO Alonso Betancourt, M Morales Herrera60. Childhood and adolescent sexual abuse - Demographic, traumatic and clinical signpostsP D Carey, J Walker, S Seedat, D J Stein61. Inositol in the treatment of obsessive compulsive DisorderP D Carey, S Seedat, D J Stein62. A review of factors associated with suicidal behaviour in children and adolescents admitted to Tygerberg HospitalT Du Plessis, S M Hawkridge, F H Theron, S A Du Plessis63. Psychological and physical outcomes of elective abortion: Local anaestheisa vs Intravenous sedationT Ericksen, S Seedat, P Labuschagne, D J Stein64. Mental health literacy of Human resource practitioners in South AfricaC J Hugo, H D Vos, D J Stein65. The importance of a specialized clinic for the care of patients with first episodes of psychosisN Keyter, P P Oosthuizen, R A Emsley, H J Turner66. Self-reort vs urinary drug screening in Schizophrenia: A pilot studyL Koen, D J H Niehaus, J E Muller, C Seller, N Keyter67. The effect of aggression on the use of Psychotropics in Schizophrenia: A naturalistic studyH Lategan, L Koen, D J H Niehaus68. Factor analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive Disorder: Clinical and genetic correlatesC Lochner, D J H Niehaus, S M J Hemmings, C J Kinnear, V A Corfield, J C Moolman-Smook, D J Stein69. Experiences in obsessive-compulsive disorder and Trichotillomania: Role of childhood traumaC Lochner, S Seedat, P D Carey, D J Stein70. Delusional systems in Xhosa Schizophrenia SibpairsJ E Muller, D J H Niehaus, L Koen, C Seller, N Keyter, C Laurent, R A Emsley71. OCD Heteogeneity reflected by lack of Genealogically determined founder effectD J H Niehaus, L Endeman, I Bosman, S Hemmings, C Lochner, L Koen, H Moolman-Smook, V A Corfield, D J Stein72. The efficacy and tolerability of low-dose vs standard dose Haloperidol in first episode Psychosis. A randomised, double-blind studyP P Oosthuizen, R A Emsley, H J Turner, N Keyter73. Treatment with low-dose Haloperidol does not protect against Tardive DyskinesiaP P Oosthuizen, R A Emsley, H J Turner, N Keyter74. Do healthcare funders discriminate against members on the grounds of mental illness?O Scholtz, P P Oosthuizen, C Hugo, B Richards75. Treatment strategies in patients with Clozapine resistant Schizophrenia at Stikland Hospital: A critical evaluation of one optionA Schulte, D J H Niehaus, L Koen, J E Muller, P P Oosthuizen, R A Emsley76. Early coadministration of Clonazepam with Paroxetine for generalised Social Anxiety DisorderS Seedat, M B Stein77. Trauma exposure and post-traumatic stress symptoms in adolescents: A schools' survey in Cape Town (South Africa) and Nairobi (Kenya)S Seedat, C Nyamap, F Njenga, B Vythilingum, D J Stein78. The QTC effects of Thioridazine when used as a second line Antipsychotic (at Stikland Hospital)C Seller, P P Oosthuizen79. Brain imaging and substance related disordersD J Stein80. Gender differences in trauma exposure & post traumatic stress disorder in a clinic sampleS Suliman, S Seedat, F Gxama, J Walker, W Rossouw81. Assessing the prevalence of anxiety and depressive symptoms among clinicians at Tygerberg Academic Hospital and controlsH Van der Bijl, P P Oosthuizen82. Pharmacological challenge with a Serotonin ID agonist in alcohol dependenceB Vythilingum, C Wessels, S Maritz, W P Pienaar, D J Stein83. The treatment of ADHD in adultsW Verbeeck

Recently, the newspapers and journals were bubbling with articles and editions devoted to various kinds of millennium and Y2K perspective. Some were retrospective and others prospective; some simply comprised lists of ‘greatests’. Interpreting the past with accuracy and insight is challenging, as is predicting the future. Fortunately, many others have already done that. So, instead, I will look at our discipline, cell biology, defined very broadly and to include molecular biology, both prospectively and retrospectively in the context of some perhaps prosaic but pertinent questions about the discipline that are surfacing as the centuries change. Many greats: One approach to summarizing the past is through lists of the greatest participants or classic papers in a given area. These lists appear frequently in areas like physics and mathematics, where progress is, or at least was, heavily influenced by heroic individuals who opened or sustained a field. In these areas, most participants and observers would develop a very similar list of the ‘greatests’, and nearly everyone working in the discipline would know what their contribution was. Is this true in cell biology? Are there names that everyone would know, or a canon of papers that everyone has read? Did the cell biology of the last 50–100 years evolve because of heroic individuals? Or were there only some insightful pioneers, followed by a large number of important accomplishments that occurred in many different laboratories? Interestingly, none of the major journals has compiled a ‘greatest’ list or even a “classic papers” list in cell biology. This is revealing. Perhaps it tells us that there were no great cell biologists - i.e. that the recent, great progress that we have witnessed didn't require great individuals. More likely, however, there are too many - that is, the advances in cell biology tend to be incremental, with many more bright sparks and contained blazes than forest fires. Seminal observations are frequent and arise in unexpected places. Progress may be better measured as the integral of many important contributions and contributors. Thus, cell biology is the product of many many great scientists, who interact, synergize and stand on each other's shoulders. The attractiveness of cell biology lies in this open, frontier culture. And the result is that the pie of success is large and that many have been rewarded. An interesting consequence of our frontier culture is that it is too exciting and fast paced for anyone to take the time to develop a sense of history and accomplishment. Sidney Brenner makes this point in his review of a book entitled ‘The lac Operon: A short history of a genetic paradigm’, by Benno Muller-Hill (Nature 386, 235). Brenner writes: “This book opens with the lament that for young molecular biologists history does not exist, and that they have no interest in the long struggle that has made the subject what it is today. I hold the weaker view that history does exist for the young, but it is divided into two epochs: the past two years, and everything that went before. That these have equal weight is a reflection of the exponential growth of the subject, and the urgent need to possess the future and acquire it more rapidly than anybody else does not make for empathy with the past.” A few years ago I read a list of the names of biomedical Nobel Laureates to some colleagues. They knew only a handful of the names and what their contributions were. It seems that so much is being accomplished so quickly it is hard for individuals to stand out. And the consequent focus on the collective achievement is what makes our discipline so rewarding for so many. But how long will this frontier culture last? The emergence of big biology, through government and private-foundation initiative, is changing the landscape. The rate of progress continues to accelerate. Will one soon require a very big lab to survive? Will creative minds find cell biology fertile territory? There are answers to big science. Most important is to embrace what it produces and look ahead. Another is to develop multi-institutional collaborative networks in which the product can far exceed the contributions of single individuals. And, finally, there are always trails to blaze and syntheses to make. They require little more than hard work, organization, good sense, perseverance, and some luck. Is it almost over? Extrapolating the rapid progress that we are witnessing, can one realistically predict what our discipline will be like over the next few decades? Will the questions that we are investigating now be answered or passe, and, if so, how soon? How long will cell biology continue to be on the center stage? Will there be new, fundamental, concepts or a paradigm shift? What ‘unexpecteds’ might we expect? At meetings over beer and at dinner tables with seminar speakers, the question “Is it almost over?” creeps in with increasing frequency. The concern is that the big picture will be in place soon - that is, the outlines of the fundamental cellular processes will be largely understood at a molecular level. This concern, of course, reflects the depth with which one wants to understand the cell. Clearly, we now know vastly more than we did even a decade ago. There is an emerging sense that a rudimentary understanding of the most basic cellular processes is in sight; one sees this even in the undergraduate cell biology textbooks. Of course, progress will continue. However, the questions about fundamental processes will become increasingly refined, and the answers more detailed - more likely to occupy space in specialty treatises than in undergraduate cell biology texts. The approaches and concepts will become more deeply linked to chemistry and physics, eventually focusing on subtleties of mechanism and structure. Some of these details will change our basic concepts dramatically; but the frequency of such occurrences will dwindle. These details are also necessary for the applications of cell biology that are beginning to emerge and for a true marriage of cell biology with the molecular world. This level of inquiry and detail, or increasing reductionism, may not sustain the interest of or resonate well with many of our colleagues. However, for others, it's just the beginning and is opening doors for a cadre of new colleagues trained in physics and chemistry to enter with fresh ideas, insights and technologies. Will it ever end? But is it almost over? Do we really know how cells do what they do? How is the thicket of seemingly redundant pathways and networks, molecules, and supramolecular assemblies coordinated spatially and temporally? Which of the many pathways and redundant mechanisms revealed in culture are utilized in vivo. How are cellular phenomena, as revealed in the spatial and temporal coordination required for cell division or migration, for example, integrated? How do groups of cells integrate and coordinate to effect tissue function, embryonic development, and pathology, for example? As we begin to observe cellular phenomena in situ, they can appear very different from those observed in culture. The compensation and redundancy seen in knockout, transgenic or mutated organisms also reveals a diversity of possible mechanisms. It seems that the cell has different ways of doing the same thing. How does the cell do it normally, and when, if ever, are the other mechanisms used? We have tended to focus the majority of our efforts on a few cell types. What about the other cells? How do they do it? These questions are especially pertinent in developmental biology and pathobiology, where the cellular environments are changing; they also point to a class of challenging, important new avenue of investigation. As the canon of cellular phenomena becomes understood at an increasingly refined level, it provides the basis for explaining integrative phenomena. It also becomes the source of interesting and important practical applications. In this way, cell biology can become the language for understanding complex integrative phenomena like learning and memory, behavior and personality - areas in which the genome project and genetics might merge to provide unique insights. In addition, cell biology is the source of endless practical applications and, in some sense, sits in the center of a booming biotechnology industry that includes novel therapeutic strategies, designer animals and plants, tissue replacements, biomaterials and biosensors. The possibilities here seem endless. What does genomics bode for cell biology? A great deal of opportunity. Do sequences, homologies, binding interactions, changes in expression, and even knockouts provide a satisfactory understanding of function? Isn't the genomic bottleneck the assignment of cellular functions to different genes? In its essence, gene function can be viewed as a cell biological issue and perhaps not fully amenable to high-throughput analysis. Thus, the genome project promises to keep cell biology on the center stage. And maybe, therefore, we will have too much to do. The devil is in the detail: A major product of the successes in cell biology is a mind-numbing number of facts, particulars, data and details. The volume of information and detail that we are generating in genome studies and cell signaling, for example, unsettles some. Will the molecular paradigm, which has been so successful and brought us here, lead us to the next level? In the reductionist paradigm, the cell can be viewed as a complex chemical system that obeys the laws of physics and the principles of chemistry. In this view, one needs to know the relevant chemical properties for all of the cellular components. Once this is known, the cellular dynamics and equilibria can be computed, and ultimately cell behavior modeled. For small systems and isolated processes, this has had an important predictive value and has been insightful and revealing. Most importantly, it uses the principles of chemistry, which is a common language that is known and understood by nearly all participants. Can this approach be usefully extrapolated to a highly complex system like an entire cell? It may take a while, as it poses some interesting challenges. How many complex differential equations, which must cover both temporal and spatial distributions, would be involved? How accurately will the concentrations and rate constants need to be measured? How does one deal with the non-ideal nature of the cell interior and exterior? The differential equations required to describe the systems of interacting pathways or networks found in a cell will necessarily be very complex and contain many terms. How does the error in measurements of the rate constants and concentrations, for example, propagate - that is, given any reasonable measurement error, can one derive anything that is meaningful and useful? The situation is complicated further by the nature of the cell. What are the effective concentrations (the activities) of the components? How does one address reactions that are occurring on surfaces or macromolecular assemblies that can be dynamic? These are formidable challenges. Chemistry faces them continually, as do other sciences that deal with complex phenomena. Natural phenomena have strong roots in the principles of physics and the concepts of chemistry. Yet the mathematics that backs them up does not readily yield to highly complex phenomena. Maybe different approaches - perhaps one based in the complex-systems theory that is so familiar to engineers - will provide an alternative. Where's the big picture? Are there other ways of dealing with our flood of details and particulars? There is a call for mathematicians, computer scientists, engineers and/or theorists to help bring order to this information flood. Can they make sense of this complexity? Are there overarching and unifying concepts that will allow us to think in generalities, rather than in particulars? There may already be some unifying concepts. One is the genetic paradigm, which views a cell's behavior as a consequence of its expressed genes. The geneticist's point of view has already provided an important, empirical and quantitative way of looking at cellular and organismal phenomena. This view of a cell or organism, or even a disease like cancer, differs greatly from that of a biochemist, which focuses on mechanisms and specifics. In some respects, it shifts attention away from the particulars and sticky mechanistic issues, and thus can be simplifying. Genetics has been a very powerful driver in many areas, not only as a tool to determine function but also as a way of looking at a process. The marriage of genetics with developmental biology is only one of many examples. A number of other examples derive from modeling. The Hodgkin-Huxley equation is one prominent and useful example. It models the axon as an electrical entity. For other purposes, the cell has been likewise treated as a mechanical entity and modeled in the jargon of mechanics. There are other ways of modeling the cell and its component processes - for example, through signal and systems theory, network and graph theory, Boolean algebra, and statistics. Each of these treatments can be meaningful and useful to those well versed in that particular discipline. But are these useful to those not versed in them? Is there a unifying theory or model that avoids a proliferation of models. How does one connect them to our chemical roots? In physics, the simplest is accepted as correct. Cell biology has a different reality. It is derived evolutionarily, and therefore, the simplest model may not be correct or even useful. Perhaps, in the future, there will even be a synthesis - like the periodic table or quantum mechanics for physics and chemistry - that allows us to deal with the mega-detail that we are generating. Big surprises in small packages: To date, cell biology has progressed rapidly because of its qualitative nature. Differences in localization are often characterized by fluorescence intensities that are described qualitatively as brighter or dimmer or as more or less localized. Similarly, differences in expression are often characterized by the intensity of bands on western blots or SDS gels; these are often described as bigger or smaller. Many changes are, in fact, very large, and this level of characterization is likely to be adequate. But have we missed anything? Is there a need for more quantitative measurements? When differences in expression are analyzed by gene array, where does one draw the line? Is a tenfold change more significant than a 2–3-fold change? Many measurements would not detect changes that are only 2–3-fold, and in others we have tended to ignore them. We wouldn't see such a small change in fluorescence intensity by eye, for example, nor would we readily identify changes in concentration that arise from differences in localization rather than expression. Ignoring small changes assumes that biological readouts are not highly poised. But is this true? Systems that have interacting components, undergo conformational changes or enzymatic modifications, or are part of amplifying cascades, for example, can be highly poised. Thus 2–3-fold changes in expression or in substrate/ligand concentration can have effects that are very large. Of course, the converse follows as well. Large changes might have only modest consequences - for example, if one is well removed from the Kd. Examples of small changes having large effects and vice versa are common features of complex systems and are now beginning to appear in the cell biology literature. It seems likely there will be many more as our measurements become increasingly quantitative. Downstream signals: What can one make of all of this? (1) This is a very, very good time for cell biology. Questions that have loomed for decades and centuries are becoming understood in a meaningful way. The progress is breathtaking; it wasn't this easy only a couple of decades ago. (2) Many are participating in the success; they are all contributing to something useful and important. (3) The devil is in the detail but so are the opportunities. (4) Big science is here to stay - perhaps a consequence of our success. As investigators, we need to embrace it and look ahead. (5) The only constant in our research will be change. We will need to be flexible in our approaches and questions. (6) We must translate our progress to the public through education and the popular press in ways that sustain their interest and support and attract new minds to our discipline. (7) The surge in new technology will continue to drive our progress, which will come to nearly anyone who works hard, chooses a good problem, and takes a reasonable approach. (8) We need to develop strategies to deal with the information flood; it won't ebb soon. And the anticipated simplifications from the mathematicians, computer scientists and modelers may take quite a while. (9) Enjoy your successes. This might be about as good as it gets.

Stress is a non-specific state of a body caused by stressors. Stressor is a stimulus which, with its activity, produces a certain response which may be: physiological, emotional, cognitive and behavioural. The purpose of the research was to determine the connection and differences between personality traits (negative affectivity, social inhibition and psychosomatic inclination) of healthy people and patients with coronary disease, as well as their role in the development of the disease. The research was conducted on the sample of 43 respondents, with and without a coronary disease. It was found that there is a link between negative affectivity and social inhibition so that these two traits can be observable with part of the sample with a coronary disease. Dimensions of A type behaviour (achievement motivation), although it cannot be claimed for sure, have a significant role in the development of a coronary disease, that is, they are more noticeable. This was confirmed by our initial assumption, where this dimension is more dominant with women who have coronary problems.

Background and aims. Diabetes mellitus and cancer are two diseases with a strong psychological impact. Personality traits modulate the perception of pain and the response to disease. The specificity of this study consists of the assessment of personality, pain and emotional impact in the two diseases. Method. The study included 130 participants assigned to 3 groups: patients with diabetes mellitus, patients with cancer disease, and a control group. The personality traits of all the participants were analyzed using Cloninger’s Temperament and Character Inventory (TCI). For the evaluation of pain, as well as associated anxiety and depression in the diabetes and cancer groups, the Brief Pain Inventory (BPI) and the Hospital Anxiety and Depression Scale (HADS) were used. Results. Patients with diabetes mellitus and cancer disease had significantly higher total values on the Harm Avoidance scale (HA) (p<0.001) and lower total values on the Self-Directedness scale (SD), Reward Dependence scale (RD), Cooperativeness scale (CO) (p<0.001) compared to the control group. Major anxiety was predominant in patients with diabetes mellitus (34%), and major depression was prevalent in cancer patients (17.5%). Patients with diabetes mellitus obtained a significantly higher severity score at BPI scale than patients with cancer disease (p=0.03). Conclusions. The existence of a mutual personality profile featuring high levels of Harm Avoidance and low levels of Self-Directedness in patients with diabetes mellitus and cancer who experience pain has great implications for the therapeutic approach. A potential future avenue of management in these diseases may lie in targeting particular personality aspects of chronic pain patients.

AbstractIndividual differences in personality are associated with variation in healthy aging. Health behaviours are often cited as the likely explanation for this association; however, an underlying biological mechanism may also exist. Accelerated leukocyte telomere shortening is implicated in multiple age-related diseases and is associated with chronic activation of the hypothalamus–pituitary–adrenal (HPA) axis, providing a link between stress-related personality differences and adverse health outcomes. However, the effects of the HPA axis are tissue specific. Thus, leukocyte telomere length may not accurately reflect telomere length in disease-relevant tissues. Here, we examined the correlation between stress reactivity and telomere length in heart and brain tissue in young (6–9 month) and aging (18 month) zebrafish. Stress reactivity was assessed by tank diving and through gene expression. Telomere length was assessed using quantitative PCR. We show that aging zebrafish have shorter telomeres in both heart and brain. Telomere length was inversely related to stress reactivity in heart but not brain of aging individuals. These data support the hypotheses that an anxious predisposition contributes to accelerated telomere shortening in heart tissue, which may have important implications for our understanding of age-related heart disease, and that stress reactivity contributes to age-related telomere shortening in a tissue-specific manner.