ABSTRACT: Patients diagnosed with multiple sclerosis (MS) are believed to undergo personality changes, which could have implications for how they perceive themselves and are perceived by others. We endeavored to examine the extent to which patients' self-perceptions are congruent with how they are perceived by significant others across five trait domains as demarcated by the well known Five-Factor Model (FFM).
The NEO Five-Factor Inventory (NEOFFI) (Costa and McCrae, 1992) was administered to women with MS (n=70) and their spouses or partners. Pearson correlations and general linear models (GLMs) were employed to test for differences between patient self-reports and partner reports of FFM traits.
Correlation analyses revealed good correspondence between patient and partner NEOFFI data in relapsing-remitting MS patients, but not secondary progressive patients. There was no significant correlation among progressive course patients for all NEOFFI domains, except Agreeableness. GLMs revealed significant differences where patients rated themselves higher than their partners rated them in Extraversion and Openness.
These discrepancies in the way patients and partners view patient personality are probably multidimensional and may have neurological and/or psychological causes. The direction of the discrepancies are consistent with some prior research suggesting MS, which is a disease affecting both the cerebral white and gray matter, may give rise to lowering in self awareness. Conversely, patients may be finding emotional or personal benefits in their response to the disease unbeknownst to partners.
Journal of Psychosomatic Research 03/2009; 66(2):147-54. · 3.30 Impact Factor
ABSTRACT: Although the cognitive disorder of multiple sclerosis (MS) is well characterized, little is known about personality changes that may occur in this disease. There are reliable personality tests available for research in neurological disease, based on the well-known Five Factor Model. Preliminary research suggests that cognitively impaired MS patients exhibit elevation in Neuroticism, and diminution in Extraversion, Agreeableness, and Conscientiousness, as do patients with Alzheimer's disease. We predicted that these characteristics would be associated with lower neocortical volume. We studied 44 patients using brain MRI and the NEO Five-Factor Inventory. Regression models controlling for T2 lesion volume, depression, and cognitive dysfunction revealed significant correlation between cortical atrophy and reduction in Extraversion and Conscientiousness. Discrepancies between patient- and informant-reports were found, and overreporting of high Openness and Conscientiousness among patients was associated with lower neocortical volume. A final regression model accounting for depression, cognitive function, and personality accounted for 38% of the variance in neocortical volume. These findings suggest that cortical atrophy in MS is associated with adverse impact on personality, although longitudinal research is needed to test this hypothesis.
Neuropsychology 08/2008; 22(4):432-41. · 3.82 Impact Factor
ABSTRACT: This study explores physicians' assistants' (PA) knowledge and practice regarding tobacco cessation counseling, approaches to lung cancer early detection and management of patients at high risk of developing lung cancer.
A cross-sectional survey design was used to examine approaches to tobacco use prevention and the early detection of lung cancer among PAs from Western New York State.
PAs report promoting use of the nicotine patch, nicotine spray and bupropion when counseling smokers on cessation. Reported management strategies for a patient at high risk of developing lung cancer were not supported by current literature.
These findings suggest the need for professional educational programs aimed not only at conveying the continued importance of tobacco cessation counseling, but also information on the appropriate management options for patients at increased risk of developing lung cancer.
Journal of Cancer Education 02/2006; 21(4):248-52. · 0.76 Impact Factor
This study examines variations in breast cancer screening among primary care clinicians by geographic location of clinical practice.
A cross-sectional survey design was used to examine approaches to breast cancer screening among physicians, nurse practitioners, and physician assistants involved in primary care practice. A summary index of beliefs about breast cancer screening was created by summing the total number of responses in agreement with each of four survey items; values for this summary variable ranged between zero and four. Respondents were classified into urban, rural and suburban categories based upon practise location.
Among the 428 respondents, agreement with "correct" responses ranged from 50% to 71% for the individual survey items; overall, half agreed with three or more of the four breast cancer screening items. While no significant differences were noted by practice location, variation in responses were evident. Reported use of written breast cancer guidelines was less in both suburban (OR = 0.51) and urban areas (OR = 0.56) when compared to clinicians in rural areas.
Development of an evidence-based consensus statement regarding breast cancer screening would support a single set of unambiguous guidelines for implementation in all primary care settings, thus decreasing variations in how breast cancer screening is approached across varied clinical settings.
BMC Public Health. 01/2003;
ABSTRACT: Guidelines for breast cancer screening often provide conflicting recommndations.
A cross-sectional survey design was used to examine approaches to cancer screening among primary care physicians.
Among the 187 respondents, levels of agreement with the "correct" response ranged between 50% and 73% for each of the four items relating to breast cancer screening; only 42% of physicians demonstrated agreement with three or more of the four items. Physician gender, specialty group, and age category were significant predictors of responses.
These findings suggest the need to implement educational interventions as one means of decreasing variation in breast cancer screening.
Journal of Cancer Education 02/2002; 17(4):205-10. · 0.76 Impact Factor