Discrepancies in Patient and Caregiver Ratings of Personality Change in Alzheimer's Disease and Related Dementias.

IF 2.1 4区 心理学 Q2 PSYCHOLOGY
Emma Rhodes, Dawn Mechanic-Hamilton, Jeffrey S Phillips, Alejandra Bahena, Nykko Vitali, Quinn Hlava, Philip Cook, James Gee, Murray Grossman, Corey McMillan, Lauren Massimo
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Abstract

Objective: Personality change in Alzheimer's disease and related dementias (ADRD) is complicated by the patient and informant factors that confound accurate reporting of personality traits. We assessed the impact of caregiver burden on informant report of Big Five personality traits (extraversion, agreeableness, conscientiousness, neuroticism, and openness) and investigated the regional cortical volumes associated with larger discrepancies in the patient and informant report of the Big Five personality traits.

Method: Sixty-four ADRD participants with heterogeneous neurodegenerative clinical phenotypes and their informants completed the Big Five Inventory (BFI). Caregiver burden was measured using the Zarit Burden Interview. Discrepancy scores were computed as the difference between patient and informant ratings for the BFI. Regional gray matter volumes from T1-weighted 3T MRI were normalized to intracranial volume and related to global Big Five discrepancy scores using linear regression.

Results: Higher levels of caregiver burden were associated with higher informant ratings of patient neuroticism (ß = 0.08, p = .012) and with lower informant ratings of patient agreeableness (ß = 0.11, p = .021) and conscientiousness (ß = 0.04, p = .034) independent of disease severity. Patients with greater Big Five discrepancy scores showed smaller cortical volumes in the right medial prefrontal cortex (β = -5.24, p = .045) and right superior temporal gyrus (β = -7.91, p = .028).

Conclusions: Informant ratings of personality traits in ADRD can be confounded by the caregiver burden, highlighting the need for more objective measures of personality and behavior in dementia samples. Discrepancies between informant and patient ratings of personality may additionally reflect loss of insight secondary to cortical atrophy in the frontal and temporal structures.

阿尔茨海默病和相关痴呆患者和护理人员人格变化评分的差异。
目的:阿尔茨海默病和相关痴呆(ADRD)患者的人格变化因患者和信息提供者因素而变得复杂,这些因素混淆了人格特征的准确报告。我们评估了照顾者负担对五大人格特征(外向性、宜人性、尽责性、神经质和开放性)举报人报告的影响,并调查了与患者和五大人格特质举报人的报告中较大差异相关的区域皮层体积。方法:64名具有异质性神经退行性临床表型的ADRD参与者及其信息提供者完成了五大清单(BFI)。护理人员的负担是通过Zarit负担访谈来衡量的。差异得分计算为患者和线人对BFI的评分之间的差异。T1加权3T MRI的区域灰质体积被标准化为颅内体积,并使用线性回归与全局五大差异评分相关。结果:护理人员负担水平越高,患者神经质的信息提供者评分越高(ß = 0.08,p=0.012),并且患者宜人性的信息提供者评级较低(ß = 0.11,p=0.021)和尽责性(ß = 0.04,p=0.034)与疾病严重程度无关。五大差异评分较大的患者右内侧前额叶皮质的皮质体积较小(β = -5.24,p=.045)和右颞上回(β = -7.91,p=0.028)。结论:ADRD中人格特征的告知者评分可能会被照顾者负担所混淆,这突出了对痴呆症样本中人格和行为进行更客观测量的必要性。信息提供者和患者的人格评级之间的差异可能还反映了额叶和颞叶结构皮层萎缩继发的洞察力丧失。
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来源期刊
CiteScore
4.60
自引率
7.70%
发文量
358
审稿时长
6-12 weeks
期刊介绍: The journal publishes original contributions dealing with psychological aspects of the etiology, diagnosis, and treatment of disorders arising out of dysfunction of the central nervous system. Archives of Clinical Neuropsychology will also consider manuscripts involving the established principles of the profession of neuropsychology: (a) delivery and evaluation of services, (b) ethical and legal issues, and (c) approaches to education and training. Preference will be given to empirical reports and key reviews. Brief research reports, case studies, and commentaries on published articles (not exceeding two printed pages) will also be considered. At the discretion of the editor, rebuttals to commentaries may be invited. Occasional papers of a theoretical nature will be considered.
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