In a community survey, subjects and their informants were asked the same questions about memory and intellectual decline in the subjects. Subjects and informants both commonly reported cognitive decline, although in most cases the decline was not seen as interfering with daily life. However, when responses from subjects and informants were cross-tabulated, agreement was found to be poor. For subjects, reports of cognitive decline were correlated with anxiety and depression symptoms and with trait neuroticism. Subjects' reports were uncorrelated with age and only weakly correlated with cognitive test performance, indicating little validity. By contrast, informants' reports were correlated with the subjects' cognitive test performance and age, but also with the informants' own anxiety and depression symptoms. Although informants' reports have validity, they may also be contaminated by the informants' affective state.

In the course of a large twin study of Alzheimer's disease we used a two-stage telephone screening procedure. The modified Telephone Interview for Cognitive Status (TICS-m) served as an initial screen for dementia in 12709 individuals. The telephone Dementia Questionnaire (DQ) was then asked of collateral informants for subjects with TICS-m scores below 28, as well as for samples of persons with higher TICS-m scores. Based upon DQ responses, individuals with cognitive impairment not attributable to focal causes underwent assessment for the clinical diagnosis of Alzheimer's disease (‘Alzheimer's dementia’), as did their twins. Well-defined Alzheimer's dementia was apparent in 39 subjects. Employing a cut-off of 27 or lower as indicative of cognitive impairment, the sensitivity of the TICS-m in the detection of Alzheimer's dementia was estimated at >99% and specificity at 86%. Inclusion of the DQ increased the specificity at the 27/28 cut-point to 99%. The TICS-m score was associated with an area under the receiver operating characteristic (ROC) curve of 0·88 (95% confidence interval 0·81 to 0·94). The maximum number of cases of Alzheimer's dementia remaining undetected in the sample was estimated to be 34.

This is a report of clinical and epidemiological trends in parasuicide in Edinburgh and Oxford over the period 1976 to 1984. Rates of parasuicide declined in both cities, but more markedly among women than men. Male rates tended to be higher in Edinburgh and female rates higher in Oxford. Age-specific rates were similar for the two cities in 1983–84, with peak rates for females among 15–19 year olds and those for males among 20–24 year olds in Edinburgh and 25–34 year olds in Oxford. Parasuicide incidence was higher in lower social class groups and among the unemployed in both cities. During the study period there was a massive decline in barbiturate overdoses, a more modest decline in minor tranquillizer overdoses but, in Oxford, a marked increase in self-poisoning with paracetamol. By the end of the study period the proportion of patients receiving a diagnosis of drug addiction had doubled in Edinburgh, although it had remained fairly constant in Oxford. There were differences in patterns of aftercare offered to patients in the two cities; these almost certainly reflect differing clinical policies.

Within minutes of leaving the consulting room, patients are frequently unable to recall what their doctor has told them. This paper describes a simple, practical method for increasing recall by the organization of medical information into ‘labelled’ categories. The success of this technique was demonstrated first in a laboratory experiment with volunteer subjects, and then in a naturalistic setting with general practice patients.

Background. A sample of 1089 Australian adults was selected for the longitudinal component of the Quake Impact Study, a 2-year, four-phase investigation of the psychosocial effects of the 1989 Newcastle earthquake. Of these, 845 (78%) completed a survey 6 months post-disaster as well as one or more of the three follow-up surveys.

Methods. The phase 1 survey was used to construct dimensional indices of self-reported exposure to threat the disruption and also to classify subjects by their membership of five ‘at risk’ groups (the injured; the displaced; owners of damaged small businesses; helpers in threat and non-threat situations). Psychological morbidity was assessed at each phase using the 12-item General Health Questionnaire (GHQ-12) and the Impact of Event Scale (IES).

Results. Psychological morbidity declined over time but tended to stabilize at about 12 months post-disaster for general morbidity (GHQ-12) and at about 18 months for trauma-related (IES) morbidity. Initial exposure to threat and/or disruption were significant predictors of psychological morbidity throughout the study and had superior predictive power to membership of the targeted ‘at risk’ groups. The degree of ongoing disruption and other life events since the earthquake were also significant predictors of morbidity. The injured reported the highest levels of distress, but there was a relative absence of morbidity among the helpers.

Conclusions. Future disaster research should carefully assess the threat and disruption experiences of the survivors at the time of the event and monitor ongoing disruptions in the aftermath in order to target interventions more effectively.

A Past History Schedule (PHS) for use in conjunction with the Present State Examination (PSE) is described. The PHS/PSE interview enables a rating of ‘lifetime ever’ psychopathology to be performed. It provides good inter-rater reliability, as well as a satisfactory agreement between retrospective interviews and casenote-based assessment of past psychopathology. The PHS has been devised specifically for use in a family-genetic study of affective illness, but the general approach may be applicable to other categories of psychiatric disorder.

In this study gender differences in coping were explored, using the Ways of Coping Checklist (WCC; Folkman & Lazarus, 1980). In addition, the focus was on sex differences in the predictive value of coping strategies in relation to psychosomatic symptoms. Males preferred problem-focused coping strategies, planned and rational actions, positive thinking, personal growth and humour, day-dreaming and fantasies. Women preferred emotion-focused coping solutions, self-blame, expression of emotions/seeking of social support, and wishful thinking/emotionality. In spite of the gender differences the results of multiple regression analyses indicated congruous relationships between coping and complaints for both sexes. Stressors and coping factors contributed in much the same way to the explained variance of symptoms and the results were generally similar for males and females. The present data also emphasize the bidirectionality of the coping–symptoms link. This holds especially for self-blame, day-dreaming and fantasizing, and wishful thinking/emotionality. In contrast, distancing was found to be associated with self-reported psychosocial load. Future prospective studies should explicitly pay attention to this bidirectional relationship.

Background. Several population-based studies have shown that self-perceived health is a powerful predictor of health outcomes. The extent to which self-perceived health is associated with personality characteristics is, however, largely unknown. We aimed to study the relationship between self-perceived health and personality among adults in the community.

Method. Data were drawn from the Midlife Development in the United States Survey, a representative sample of adults age 25–74. MANOVA was used to determine the relationship between self-perception of health and personality using the five-factor model.

Results. Personality factors were significantly associated with perception of poor health. Among those without self-reported medical problems (N = 834), openness to experience, extraversion and conscientiousness were associated with perception of good health, while neuroticism was associated with the perception of poor health. In subjects with self-reported medical problems (N = 2772), high scores on agreeableness, openness to experience, extraversion and conscientiousness, and low neuroticism scores were associated with perception of good health. These associations remained significant after adjustments for age, gender, race, marital status and education.

Conclusions. Self-perceived health is strongly associated with personality characteristics, both in subjects with and without self-reported medical problems. It is suggested that personality characteristics could contribute to the previously reported associations between self-perceived health and health outcomes.

Brown and his colleagues have presented evidence for the social origins of depression from results of 2 community surveys in Camberwell. This paper examines critically their methodology, conceptualization of variables, mode of argument and statistical techniques. Log-linear analysis of their published data fails to substantiate their differentiation of risk variables into vulnerability factors and provoking agents.

The Psychogeriatric Assessment Scales (PAS) provide an assessment of the clinical changes seen in dementia and depression. Principal components analysis and latent trait analysis were used to develop a set of scales to summarize these clinical changes. There are three scales derived from an interview with the subject (Cognitive Impairment, Depression, Stroke) and three from an interview with an informant (Cognitive Decline, Behaviour Change, Stroke). Results are reported on the reliability and validity of these scales using data from clinical samples in Sydney and Geneva and a population sample from Canberra. The scales were found to have excellent validity when judged against clinical diagnoses of dementia and depression and could distinguish Alzheimer's from vascular dementia. Cut-off points were developed to indicate correspondence between scale scores and clinical diagnoses. Percentile rank norms were developed from the Canberra population sample. The PAS is easy to administer and score and can be used by lay interviewers after training. It is intended for application both in research and in services for the elderly.

Background. This study examined the relationships between self-reported childhood sexual abuse (CSA) and drug-related outcomes in an Australian twin panel.

Method. A semi-structured psychiatric interview was conducted in 1996–2000 by telephone with young adult Australian twins (mean age 29·9 years). Data reported here are from 6050 twins who responded to both CSA and drug-related items.

Results. A history of CSA was associated with significant risk for subsequently occurring regular smoking and use of each illicit drug class. Further CSA-associated risk was found among regular users, for nicotine and alcohol dependence, and among illicit drug users, for abuse/dependence of most drug classes. In same-sex discordant pairs, significant risk for regular smoking and illicit drug use was found in twins with a history of CSA compared to their non-abused co-twins. Similar analyses for abuse/dependence found significant risk for opioids, any illicit drug, and any non-cannabis illicit drug. CSA was associated with significantly earlier drug use. Despite the association of CSA with risk for early-onset cannabis use and regular smoking, risks for illicit drug outcomes associated with CSA and with either form of early-onset use combine in near-additive fashion.

Conclusions. CSA is associated with risk for subsequently occurring regular smoking and illicit drug use and abuse/dependence. Risks for drug use are mildly attenuated with control for familial contributions; similar risks for abuse/dependence remain significant for opioids and for illicit drugs combined across classes. Although we found evidence of earlier onset drug use with CSA, risks associated with CSA and with early-onset use combine in a largely additive manner.

Background. This study examined the association between a diagnosis of traumatic grief and quality of life outcomes.

Method. Sixty-seven widowed persons were interviewed at a median of 4 months after their loss. The multiple regression procedure was used to estimate the effects of a traumatic grief diagnosis on eight quality of life domains, controlling for age, sex, time from loss and diagnoses of major depressive episode and post-traumatic stress disorder.

Results. A positive traumatic grief diagnosis was significantly associated with lower social functioning scores, worse mental health scores, and lower energy levels than a negative traumatic grief diagnosis. In each of these domains, traumatic grief was found to be a better predictor of lower scores than either major depressive episode or post-traumatic stress disorder.

Conclusions. The results suggest that a traumatic grief diagnosis is significantly associated with quality of life impairments. These findings provide evidence supporting the criterion validity of the proposed consensus criteria and the newly developed diagnostic interview for traumatic grief – the Traumatic Grief Evaluation of Response to Loss (TRGR2L).

Twenty-two men, who had been forcibly sexually assaulted, participated in a study to determine the circumstances of the attacks and the effects on the victims. The immediate and long-term responses were very similar to those described in female victims of rape.

Background. Borderline personality disorder (BPD) is characterized by an emotionally unstable and impulsive cognitive and behavioral style. Inhibitory dysfunction has been hypothesized as playing a crucial role in BPD psychopathology. This study aimed to systematically investigate differential inhibitory functions in patients with BPD as compared to healthy controls, and to investigate their expected impairment in the context of aversive emotions by comparing performances in neuropsychological tasks that present both neutral and emotional material.

Method. Unmedicated female patients with BPD (n=28) were compared with age-matched healthy female controls (n=30) in the following tasks: the emotional Stroop test (inhibition of interference), directed forgetting (intentional, resource-dependent inhibition), and an emotional variant of the negative priming task (automatic, resource-independent inhibition).

Results. In comparison with the controls, the BPD patients showed reduced inhibition of negative material in the directed forgetting task and in the negative priming task. No effect was found in the emotional Stroop test. Significant correlations with current affect as well as trait anxiety and anger (but not impulsiveness) were found in the BPD group specifically for negative stimuli, while no such correlations were found in the control group. In addition to inhibitory deficiencies, BPD patients had difficulties remembering positive words in the directed forgetting task.

Conclusions. Our data suggest that individuals with BPD have difficulties in actively suppressing irrelevant information when it is of an aversive nature. Inhibitory dysfunction appears to be closely related to state and trait variables of unstable affect, but not to self-reported impulsiveness.