Deviate N200 Component of Event-Related Potentials in Shuchaku-Seikaku, a Premorbid Personality of...

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The Japanese Journal of Psychiatry and Neurology, Vol. 45, No. 3, 1991 Deviate N200 Component of Event-Related Potentials in Shuchaku-Seikaku, a Premorbid Personality of Depression Chikara Ogura, M.D., Yasuhiro Nageishi,* Kozo Fukao, M.D., Yoshie Shimoji, Kiyoshi Hirano, Hiroto Hokama, M.D., Norifumi Kunimoto, M.D. and Minoru Shimokochi, M.D. * Department of Neuropsychiatry, University of the Ryukyus School of Medicine, Okinawa *Department of Behavioral Physiology, Faculty of Human Sciences, Osaka University, Osaka Abstract: Twenty-one healthy subjects with Shuchaku-Seikaku (SS), a prem,orbid per- sonality of depression, and 44 control subjects were tested for event-related potentials using the auditory odd ball paradigm. A higher percent of the N200 component was evoked by frequent task-irrelevant stimuli in the Shuchaku-Seikaku (81.0%) subjects than in the controls (45.5%). The mean amplitudes in the 50-100 ms latency range for task-relevant rare stimuli were smaller; whereas, the amplitudes in the 100-200 ms range for task-irrelevant frequent stimuli and the amplitudes in the 200-260 ms range for both stimuli were larger (shifted to negative direction) in the SS subjects than in the controls. The evidence suggests that the fully automatic detection process, which is assumed to be correlated with mismatch negativity, is hypoactivated and that a contrarily controlled or conscious mismatch process, which may be N2b, is hyperactivated in SS. Key Words: event-related potential (ERP), N200, Schuchaku-Seikaku, personality, Jpn J Psychiatr Neurol 45: 641-651, 1991 Shimoda-Shiki-Personality Znventory (SPI) INTRODUCTION Shuchaku-Seikaku (Shuchaku-the tend- ency for obsessive preoccupation with cer- tain thoughts and affairs; Seikaku-charac- ter) is a type of personality often seen as a premorbid personality of depression, particu- larly in Japan.5 l7 This personality is char- acterized as being eager to work, fastidi- Received for publication on Jan. 9, 1991. Mailing address: Chikara Ogura, M.D., De- partment of Neuropsychiatry, University of the Ryukyus School of Medicine, 207 Uehara, Nishihara, Okinawa 903-01, Japan. ous, industrious, punctilious, scrupulous, and having a strong sense of responsibility. We, therefore, assume that subjects with Shu- chaku-Seikaku (SS) will attend even to a task-irrelevant stimulus (not being able to ignore it) although subjects without SS are not always affected by such a stimulus. In other words, the former subjects are assumed to process a task-irrelevant stimulus in the same manner as a task-relevant stimulus. The experiment reported here was designed to examine this hypothesis by the use of event-related potential (ERP) measure- ments.

Transcript of Deviate N200 Component of Event-Related Potentials in Shuchaku-Seikaku, a Premorbid Personality of...

The Japanese Journal of Psychiatry and Neurology, Vol. 45, No. 3, 1991

Deviate N200 Component of Event-Related Potentials in Shuchaku-Seikaku, a Premorbid Personality of Depression

Chikara Ogura, M.D., Yasuhiro Nageishi,* Kozo Fukao, M.D., Yoshie Shimoji, Kiyoshi Hirano, Hiroto Hokama, M.D.,

Norifumi Kunimoto, M.D. and Minoru Shimokochi, M.D. * Department of Neuropsychiatry, University of the Ryukyus School of Medicine, Okinawa

*Department of Behavioral Physiology, Faculty of Human Sciences, Osaka University, Osaka

Abstract: Twenty-one healthy subjects with Shuchaku-Seikaku (SS), a prem,orbid per- sonality of depression, and 44 control subjects were tested for event-related potentials using the auditory odd ball paradigm. A higher percent of the N200 component was evoked by frequent task-irrelevant stimuli in the Shuchaku-Seikaku (81.0%) subjects than in the controls (45.5%). The mean amplitudes in the 50-100 ms latency range for task-relevant rare stimuli were smaller; whereas, the amplitudes in the 100-200 ms range for task-irrelevant frequent stimuli and the amplitudes in the 200-260 ms range for both stimuli were larger (shifted to negative direction) in the SS subjects than in the controls. The evidence suggests that the fully automatic detection process, which is assumed to be correlated with mismatch negativity, is hypoactivated and that a contrarily controlled or conscious mismatch process, which may be N2b, is hyperactivated in SS.

Key Words: event-related potential (ERP), N200, Schuchaku-Seikaku, personality,

Jpn J Psychiatr Neurol 45: 641-651, 1991

Shimoda-Shiki-Personality Znventory (SPI)

INTRODUCTION

Shuchaku-Seikaku (Shuchaku-the tend- ency for obsessive preoccupation with cer- tain thoughts and affairs; Seikaku-charac- ter) is a type of personality often seen as a premorbid personality of depression, particu- larly in Japan.5 l 7 This personality is char- acterized as being eager to work, fastidi-

Received for publication on Jan. 9, 1991. Mailing address: Chikara Ogura, M.D., De-

partment of Neuropsychiatry, University of the Ryukyus School of Medicine, 207 Uehara, Nishihara, Okinawa 903-01, Japan.

ous, industrious, punctilious, scrupulous, and having a strong sense of responsibility. We, therefore, assume that subjects with Shu- chaku-Seikaku (SS) will attend even to a task-irrelevant stimulus (not being able to ignore it) although subjects without SS are not always affected by such a stimulus. In other words, the former subjects are assumed to process a task-irrelevant stimulus in the same manner as a task-relevant stimulus. The experiment reported here was designed to examine this hypothesis by the use of event-related potential (ERP) measure- ments.

642 C. Ogura et af.

Results of ERP studies suggest that N2b, a sub-component of N200, is correlated with a controlled or conscious mismatch detec- tion process9 because it is elicited by a task-relevant rare stimulus but not by a task- irrelevant frequent stimulus. If our assump- tion is correct, in subjects with SS, N2b would be elicited by a task-irrelevant fre- quent stimulus as well as by a task-relevant rare stimulus.

An enhanced amplitude in the N200 latency range that was produced by task- irrelevant frequent stimuli was observed in depresszd patients. It was present even in the remission state after medication had bezn given.14 l5 A further study revealed that N2b also was provoked by task-irrele- vant frequent stimuli even during remission in depressed patients.14 Consequently, N200 (in particular, N2b provocation to frequent stimuli) may bz dependent on the trait of depression. These findings suggested that N200, espxially N2b, would be elicited by frequmt stimuli in healthy subjects with SS.

SUBJECTS AND METHODS

Twenty-one subjects with SS (15 males and 6 females, aged 18-22, mean age 19.3 -t 1.3) were selected from 378 under- graduates (males 259 and females 119) at the University of the Ryukyus on the basis of the Shimoda-Shiki Personality Inventory (SPI). Details are given in the Appendix. The subjects who scored 14 or higher on the SS (immodithymic) raw score were desig- nated as having S S . This group deviated from the 378 total population at the 95% per- centile. Forty-four controls (31 males and 13 females, aged 18-22, mean age 20.5 _t 1.4) were selected randomly from 188 of the control group data base. Sex, age and the length of education were matched fairly well between the two groups. The personality test was not performed on the control subjects, but the mean of the S S raw score for an 876-student sample was 8.1 I+ 4.3.19 26 All the subjects used were free from known

neurological or psychiatric diseases, addic- tion and hearing loss. Those subjects with a disposition and previous history of psychi- atric disease were excluded. No medication was taken by any subject for at least one wzek before the ERP recording session.

ERPs were recorded during an oddball task. The stimuli consisted of a 1 KHz tone- burst (frequent-nontarget stimulus) and a 2 KHz tone-burst (rare-target stimulus). The respective probabilities of the rare and fre- quent stimuli were 0.2 and 0.8. Stimuli were presented in random order. The duration of each stimulus was 90 ms with rise and fall times of 10 ms. The stimulus intensity was approximately 75 dB SPL for all the stimuli. Interstimulus intervals were 1.7 -t 0.1 sec- cnds. The subjects were instructed to count the number of rare tones and report it after each run. A run consisted of 80 stimuli. To familiarize the subjects with the task, short practice runs preccded the ERP-recording runs.

Scalp EEGs were recorded from Ag-AgCI disc electrodes placed at the midline frontal (Fz), central (Cz) and parietal (Pz) that were referred to linked earlobes (impedances less than 5 kn ) . EOGs were recorded from electrodes placed above and bzlow the right eye. The EEGs and EOGs were amplified by amplifiers having a bandpass of 0.16 (tc = 1.0 sec)-30 Hz, after which they were sampled at the rate of 2.4 ms per point with a laboratory computer (NEC-SANE1 7T17) then separately averaged for the rare and frequent stimuli. Trials were automatically rejected from the averages if at any time during the averaging epoch the voltage ex- ceeded & 100 pV in the EOG lead. The averaged potentials after the tone presenta- tions were related to the mean potential of the prior 120 ms period.

Measures of the peak amplitude and la- tency for NlOO and P200 were derived from ERPs for individual subjects for both the rare and frequent stimuli, but those for N200 and P300 only for the rare stimuli. NlOO and N200 were defined as the respective

N200 Abnormality of ERPs in Shuchaku-Seikaku 643

maximum negative peaks in the latency ranges of 75-150 and 180-300 ms after the stimulus onset. P200 and P300 were defined as the respxtive maximum positive peaks in the latency ranges of 115-230 and 240-450 ms. To evaluate the group differences in the N200 latency range (50-260 ms) in detail, we measured the mean amplitudes in the fol- lowing three latency ranges: 50-100 ms for MMN, 100-200 ms for a composition of MMN and a part of N2b, and 200-260 ms for N2b bzcause a reasonable estimate showed that MMN started from 50-70 ms p3st-stimulus onset and ended before 200- 250 ms and that N2b started from about 101)-150 ms and ended before 250-300 ms.l' 12

A three-way mixed typz ANOVA with one between-group factor (porsonality; SS and control) and two within-subject factors (stimulus condition and electrode) was per- formed on each of the NlOO and P200 peak measures and on the N200 mean amplitude measures. A two-way mixed type ANOVA with 1 bctween-group factor (personality) and 1 within-subject factor (electrode) was performed on each of the N200 and P300 peak measures. When interaction was de- tected, two-way mixed typ: ANOVAs (per- sonality X stimuli or personality X elec- trcde) or a one-way ANOVA (personality) were performed to specify the source of the interaction. To control Type I error, we re- ducod the degrees of freedom for F-values to repeated measures to 1 / (N- 1 ) .

RESULTS

Peak Latencies

In both groups NlOO and P200 were evoked to both the rare and frequent stimuli (Fig. 1). N200 and P300 appear on the ERPs to rare stimuli and on the difference ERPs. The latencies of the peaks of Nl00 and P300 were almost equal for both groups. The latencies of P200 and N200 were longer in the subjects with SS than in the controls

(Fig. 1 ) , For example, the latency of P200 to frequent stimuli was longer in SS [185.4 k 18.8 ms (Fz), 186.3 * 18.9 ms (Cz) and 187.3 +- 24.6 ms (Pz)] than in the con- trols [172.7 k 16.2 ms (Fz), 172.5 t 16.3 ms (Cz) and 172.8 t 17.9 ms (Pz)]. A statistical analysis showed a significant group differenco for the P200 latency [F( 1,63) =

7.78, p < 0.011; but, no significant group difference was detected for the N200 latency (Table 1 ) . Peak A m p lit udes

The pzak amplitudes of NlOO in the SS subjests were -8.1 k 2.6 pV (Fz), -6.9 k 2.5 pV (Cz) and -4.1 t 2.3 pV (Pz) to rare stimuli, and -8.5 t 3.0 pV (Fz), -7.3 I+ 2.4 pV (Cz) and 4.6 t 1.9 pV (Pz) to frequent stimuli. The amplitudes in the controls were -8.7 I+ 2.4 pV (Fz), -7.4 +- 2.7 pV (Cz) and -4.9 t 2.4 pV (Pz) to rare stimuli, and -7.4 t 2.2 pV (Fz) , -6.3 2 2.3 pV (Cz) and -4.1 t 2.0 pV (Pz) to frequent stimuli. A statistical analysis indicated an interaction between group and stimulus [F( 1,63) = 7.78, p < 0.011. The amplitudes to rare stimuli were larger than those to frequent stimuli in the controls [F(1,63) = 12.34, p < 0.0051, but this stimulus difference was not detected in the SS subjects.

The peak amplitudes of P200 to rare stimuli were nearly equal for the two groups (Fig. 1 ) ; but, those of P200 to frequent stimuli wcre smaller in the SS [2.2 t 2.5

Table 1: Means (SD) of the Peak Latency and Amplitude of N200 to Rare Stimuli

Amplitude (PV) Group Electrode L:gy

Shuchaku- Fz 231.7 (20.2) -4 .0 (3.73) Seikaku Cz 226.0 (19.9) 0 .7 (4.78)

Pz 220.9 (22.5) 3 . 3 (5.40)

Cz 219.4 (23.9) 0 .6 (3.68) Pz 216.5 (23.4) 2 .3 (3.45)

Control FZ 228.6 (22.0) -3.3 (3.68)

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r a r e f r e q u e n t d i f f e r e n c e

A

Pz A

Fig. 1: Grand mean waveforms of ERPs for subjects with Shuchaku-Seikaku (SS) and for the controls. Solid lines: subjects with SS ( N = 21). Broken lines: the controls (N = 44).

pV (Fz), 5.3 2.4 pV (Cz) and 5.0 -+ 2.2 pV (Pz)] than in the control [4.4 & 2.8 p V (Fz), 6.1 ? 2.6 pV (Cz) and 4.9 & 2.1 pV (Pz)] subjects, particularly at Fz. An anal- ysis showed a group X stimulus X electrode interaction [F(2, 126) = 5.40, p < 0.011. A two-way ANOVA performed on the amplitudes to frequent stimuli showed an interaction between group and electrode [F(l, 63) = 10.45, p < 0.011, but the anal- ysis of the amplitude to rare stimuli did not. The t-test, done on each stimulus X elec- trode level, showed a significant group dif- ference only for the amplitudes to frequent stimuli at Fz [t(63) = 3.04, p < 0.001]. We concluded that the amplitudes of P200 to frequent stimuli at Fz were lower in the subjects with SS than in the controls.

The peak amplitude of N200 to rare

stimuli at Fz appears to be higher; i.e., it was shifted in a more negative direction in the SS subjects than in the controls (Fig. 1, Table 1). A two-way ANOVA performed on those measures, however, gave neither a significant group effect nor a significant group X electrode interaction [F( 1,631 =

2.16, p < 0.101. Although N200 to frequent stimuli was not clearly seen in the controls, it was recognizable in the grand mean wave- forms of the SS subjects (Fig. 1 ), especially at the Fz site. An examination of the wave- forms of individual subjects showed that in 20 of 44 (45.5%) controls and 17 of 21 (81.0%) SS subjects N200 was evoked (Fig. 2). The Chi-square test revealed that the percentage of provocation of N200 by frequent stimuli was higher in the SS than in the control subjects (p = 0.04, Yate’s

N200 Abnormality of ERPs in Shuchaku-Seikaku 645

Fig. 2: Percentage of N200 provocation for frequent task irrelevant stimuli.

correction). No measurement was made of an N200 peak amplitude because the num- ber of subjects for which the N200 com- ponent to frequent stimuli could be specified was relatively small, particularly in the con- trol group.

The amplitudes of P300 at Cz and Pz appear to be larger in the SS subjects [14.0 t 4.8 pV (Cz) and 16.8 A 5.3 pV (Pz)] than in the controls [12.6 t 5.3 pV (Cz) and 14.8 t 5.3 pV (Pz)]; but, analyses of

50-1 OOms

the P300 peak amplitudes revealed no sig- nificant group effect (F < 1.0). Further- more, the group X electrode interaction did not reach significance [F(1,63) = 3.37, p < .lo], nor did the group difference for the amplitudes at Pz show significance [t(63) = 1.41, p < .20].

Mean Amplitudes for the N200 Latency Range

The amplitudes of the difference ERPs were lower (especially at Fz and Cz) in the N200 latency range (50-260 ms) for the S S than for the control subjects (Fig. 1) . Therefore, the mean amplitudes of the laten- cy range were compared separately for three successive latency ranges in both groups (Fig. 3) . An analysis of the 50-100 ms mean-amplitude measures revealed a signifi- cant interaction between group and stimulus (Table 2) . A post-hoc test indicated that the amplitude to the rare stimuli was lower in the SS than in the control subjects [F( l , 63) = 4.40, p < 0.051, but the amplitude to frequent stimuli did not differ for the two groups. An analysis of the 100-200 ms data gave a significant interaction between 3

100-200ms

0' : FZ Cz R Fz Cz Pz

*3L Fz h RFz c2 R

200-260ms

)Iy.

L Fz Cr RFz Q R

Fig. 3: Mean amplitudes of three components for subjects with SS and for the controls. Solid lines: subjects with SS (N = 21); Broken lines: the controls (N = 44). Right column in each latency range is for the amplitudes to rare task-relevant stimuli; the left one is for the amplitudes to frequent task-irrelevant stimuli.

646 C. Ogura et al.

Table 2: Summary of ANOVAs of Three Mean Amplitudes in the N200 Latency Range

- Reduced Latency Range

Sources d.f. d.f. 50-100 100-200 200-260 ms

Group (G) 1,63 1,63 0.64 3.44 0.80 Stimulus (S) 1,63 1,63 0.02 4.64* 0.03 Electrode (E) 2,126 1,63 I17.01*** 89.05*** 154.47***

G x S 1,63 1,63 10.53** 3.77 0.13 G x E 2,126 1,63 1.08 1.15 3.76 S x E 2,126 1,63 0.37 6.93** 71.13*** G x S x E 2,126 1,63 2.60 6.50** 0.41

* P < 0.05, ** p < 0.01, *** p < 0.001

factors, an indication that those amplitudes did not differ between the groups for rare stimuli; but, for frequent stimuli the ampli- tudes of the SS subjects were larger (shifted to negative direction) than those of the con- trols for the Fz and Cz records. The three- way interaction was supported by a series of post-hoc comparisons [one-way ANOVAs (group effect) performed on the mean am- plitudes to frequent stimuli: Fz; F( 1,63) =

11.08, p < 0.002, CZ; F(l, 63) = 6.97, p < 0.02, and Pz; F(1,63) = 1.94, p < 0.2), one-way ANOVAs to rare stimuli: Fs < 1.01. For the 200-260 msec mean- amplitude measures, the group X electrode interaction did not reach significance for the reduced d.f., but it was significant for the conventional d.f. (F = 3.76, df = 2,126, p < 0.05), (Table 2). A post-hoc test indi- cated that the ERPs for the SS subjects were higher (shifted to negative direction) than for the controls for the Fz record [F(1,63) = 4.25, p < 0.051 but that they did not differ for the Cz and Pz records (Fs < 1 ) .

DISCUSSION

Shuchaku-Seikaku (SS) is a common pre- morbid personality of affective disorders (in particular of major depression [DSM-III- R]), in Japan.18 Except for a few psychi- atric professionals in Europe, this type of personality is not familiar outside Japan. SS

was first reported by Shimoda, M.”’ l7 and was introduced abroad as “Immodithymie von Shimoda” by Shinfuku, N. and Iida, S. ( 1969)lS. Tellenbach, H. ( 1974)21 quoted this personality in his monograph and Videbech, Th. ( 1 9 7 5 P described this per- sonality as Shujaku-Seikaku. The term Shu- chaku is now used instead of Shujaku be- cause the latter is the old Japanese pro- nunciation, Shuchaku being the more recent one.

Shimoda, M. (1941, 1950)“’ l7 stated that the basic temperament of this person- ality is abnormality in feeling; the tendency for a feeling which is once experienced to last longer and/or be augmented, whereas the same feeling diminishes with time in normal subjects. Regarding the outbreak of affective psychosis, the malfunction of ex- citation of feeling which exists in SS pro- hibits the person from resting when ex- hausted owing to an overwork situation (precipitating factor) for some period of time. There has been argument about the characteristics and psychopathology of this personality, especially in relation to the pathogenetic interpretation of depression. Kimura, B.’j reported that it is impossible to explain every outbreak of affective psychosis as being caused by an overwork situation for a period of time in SS. Hirasawa, H. ( 1962y described the basic characteristic of this personality as punctiliousness rather

N200 Abnormality of ERPs in Shuchaku-Seikaku 647

than the perfectionism and enthusiasm re- ported by Shimoda. Whatever terms are used, Shimoda’s SS has had an impact on the study of depression in Japan, in particu- lar on the relationship between premorbid personality and life events5

The Shimoda-Shiki Personality Inventory (SPI) , in Japanese, was used to recruit sub- jects with SS. Although the validity and reliability of the original Japanese version of SPI have been confirmed, the validity of the English translation has yet to be con- firmed.

Results of our study indicated that a higher percentage of N200 to frequent stimuli was evoked in the SS subjects (17 out of 21, 81.0%) than in the controls (20 out of 44, 45.5%). Even though no com- parison of the peak amplitude of N200 to frequent stimuli could be performed because of the low percentage of provocation in the controls, the mean amplitudes (including the N200 latency range) could be compared be- tween the two subject groups. The mean amplitudes in the 50-100 ms latency range to rare stimuli were lower, whereas the amplitudes in the 100-200 ms range to fre- quent stimuli and the amplitudes in the 200-260 ms range to both stimuli were larger (shifted to negative direction) in the SS than in the control subjects. This evi- dence suggested that the amplitude reduction in the early latency range should be re- garded as hypoactivity of mismatch nega- tivity (MMN), and the high amplitudes in both the middle and late ranges may repre- sent provocation of N2bS9 lo Mismatch nega- tivity is regarded as a fully automatic cere- bral response to a stimulus that physically deviates from stimuli of the immediate past. N2b is assumed to be correlated with a con- trolled mismatch detection p r o c e s ~ . ~ lo Our results suggest that there is some deficit in the fully automatic detecting process for task-relevant rare stimuli and provocation of the controlled mismatch process for task- irrelevant frequent stimuli in the SS subjects. The P200 latency was longer, and the P200

amplitude to frequent stimuli at Fz was lower in the SS than in the control subjects. Although the psychophysiological meaning of P200 has yet to be clarified, our findings for P200 may be related to the deviate N200 described previously in the SS subjects.

It is not easy to explain the relationship between these ERP findings and the charac- teristics of SS, but it is interesting that cer- tain psychophysiological deviations exist in this type of personality. Although it is un- certain which is the primary deviation, the clinical characteristics of SS may indicate that provocation of the controlled process, even for task-irrelevant stimuli, is primary. Consequently, the hypoactivity of the auto- matic process for task-relevant stimuli would occur; but, the opposite speculation cannot be ruled out. In any case, such deviations affect rational information processing ad- versely because much more effort is being paid to task-irrelevant stimuli, and the ac- tivity of the automatic process for task-rele- vant stimuli is decreased in the SS subjects. These deviations may represent a cognitive deviance which the SS subjects already have and may not be due to exhaustion caused by executing a long-term cognitive task be- cause the duration of the experiment was only 20-30 minutes and the task was very easy to pzform. Taken together our evi- dence and discussion suggest that a deviate N200 and a related cognitive deviance may produce problems for information process- ing, especially during long-lasting stress situations. As similar ERP findings have been recognized in depressed patients during remissionI4 15, our findings for N200 may reflect the vulnerability of depression.

Since Kretschmer first addressed “Kor- perbau und Character” in 19217, several papers have been published which investigate the relationship between a cyclothymic per- sonality (Kretschmer, E.’) or syntonic per- sonality (Bleuler, E. 19552) and manic depressive psychosis. The affinity of Typus melancholicus (Tellenbach, H. 196lZo) for depression also has been discussed. More-

448 C. Ogura et al.

over, attention has been paid to obsessive personality (Munchie, W. 193 Is, Titley, W.B. 1 9 3 P ‘ ) and to anancastic personality (Videbech, Th. 197P) as premorbid per- sonalities of affective disorders.

Akiskal, H.S. et al. (1983)l concluded the following in their review article on the relationship of personality to affective dis- orders: Current evidence is strongest for introversion being a possible premorbid trait in primary nonbipolar depression; whereas, driven, work-oriented obsessoid, extroverted, cyclothymic and related dysthymic tempera- ments appear to be precursors of bipolar disorders. Other personalities, while not necessarily pathogenic in affective disorders, nevertheless may modify the clinical expres- sion of those disorders and their prognoses. But, as Akiskal, H.S. et ul? stated, definitive findings relating to personality to affective disorders have yet to emerge, hence the above conclusion is a tentative one.

The results of the research reported here should bs a valuable contribution to studies on what type of personality is related to depression because the same physiological ERP findings obtained for healthy subjects with S S have been recognized in depressed patients, even in the remission state.’” l5 Furthermore, Japanese psychiatrists have established the existence of S S from their clinical experiences and often see depressed patients with SS.ls The evidence strongly suggests that at the very least SS is one type of premorbid personality of depression. The pathogenetic factors of depression are, of course, complex and include genetic, bio- chemical, endocrinological, psychological and psychosocial factors. S S may be one of the pathogenetic factors.

Future research should include 1 ) a topo- graphical approach to ERPs; 2) a follow-up study on ERPs in S S subjects until the out- break of depression (if possible); 3 ) com- parisons of the ERPs for S S , obsessive per- sonality, cyclothymic personality, introver- sion-extroversion, etc. ; 4) consideration of the heterogeneity of affective disorders; and

5) improvement of personality assessments, including self-assessment and observations made by others.

APPENDIX

Shimoda-Shiki Personality Inventory (SPI) The Shimoda-Shiki Personality Inventory

(SPI) is a self-report inventory whose purpose is the careful psychometric development of personality assessment as objectified by Shimo- da’s personality theory, mainly Shuchaku- Seikaku. It was developed in 1982 by Tanaka, Yoshioka and Shiomilg. The characters meas- ured by the SPI are six constructs: autistic or schizophrenic character, nervous character, self-uncertain character, syntonic character, hysterical character and immodithymic char- acter (Shuchaku-Seikaku, SS). The SPI has been carefully constructed in terms of psy- chometry, items being selected for the final version in 1985. The SPI also has a Lie Scale that increases the validity of the test. The test, itself, consists of 70 statements (in- cluding reversal statements), and each scale has 10 statements to which the subject must respond “true,” “cannot say” or “false.” Each response is weighted with “2,” “1” or “0” points in the direction of the character trend. The raw scores (0-20) for each scale are con- verted to standard scores on the basis of previous SPI results for a student sample (n = 876). The SS score group mean was 8.1 k 4.3 in the final version. The 10 SPI statements related to SS are 4, 1 1 , 18, 25, 32, 39, 46, 53, 60 and 67.

The 70 statements included in the SPI are: I usually would rather be shut in my own world than to do anything else. I am nervous. I lack self-confidence and am not satis- fied with anything. Others say I am too sober. I am more easy-going and cheerful than others. I am more jealous than others. I don’t have any secrets about myself which I keep from others. I like solitude more than most people. I don’t worry much about distress. I am underestimated by others because I often am hesitant. I usually severely oppose others’ in- justice and negligence. I don’t have strong likes and dislikes about anything.

N200 Abnormality of ERPs in Shuchaku-Seikaku 649

autistic character

nervous character

I am a vain person. All my habits are good ones. I don’t believe things easily. I am a person who is terribly afraid of insects and reptiles. I always think I am inferior to others. I am apt to become engrossed with things and overwork. I like joking and often make someone laugh by my jokes. I am sometimes told that I should not take advantage of others’ kindnesses.

I 2 3 4 5 6 7 8 2 1 0 1 1 1 2 13 20 semi t ive unsociable hard to please oversensitive easi I Y becomes I I 1 very strict idea of cleanliness

I 2 3 4 5 6 7 8 9 1 0 l i 1 2 ’ 1 3 20

21) I sometimes speak abusively to others. 22) Some people say that I am very hard

to please or am hard to understand. 23) When I travel, I am often troubled by

constipation, diarrhea and sleeplessness. 24) I am faint-hearted and shy. 25) My sense of responsibility may be too

strong. 26) I am a good mixer and have many

friends. 27) I am a man of weak will and can’t resist

temptation.

self-uncertain character

irnmodi thymic character (Shuchaku.Seikaku)

synton IC chartcter

Table of SPI Scores

1 2 3 4 5 6 7 8 9 10 I 1 12 13 14 15 16 17 18 19 20 lack of confidence infer ioritu complex always concerned about one’s self

enthusiastic in work fastidious cheerful op t inistic frank. sociable

i ’ ious I 2 3 4 5 6 7 8 9 1 0 1 1 1 2 1 3 1 4 1 5 20

1 2 3 4 5 6 7 8 9 Ill I I 12 13 14 15 16 17 18 19 20

subtotal total

hvster ical character

Lie scale

SPI Profiles

I 1 2 3 4 5 6 7 8 9 10 I 1 12 13 14 15 16 17 I8 19 20 fickle

fond of show exaggerated I 1 I I

scale for verification More than 9 points on the scale show that the evaluation of reliabiity is lo1

Sca I e I 1 characteristics

of character

I Standard Score

1 - 34 35 - 44 45 - 54 55 - 64 65 -

C. Ogura el al.

I never find vulgar jokes funny. People tell me that they cannot under- stand what I am thinking. My health is apt to be bad when I am tense or have worries. I can behave feely before people who are close to me, but I become timid before elders or strangers. I like keeping my things in good order. I soon become accustomed to a new environment. Small matters either make me happy or bad tempered. I want everyone to like me rather than to dislike me. I am indifferent to many things and don’t care about it. When I become anxious I am apt to become very perplexed. I am weak in speaking in public be- cause of my shyness. I am overly obstinate. I like to be of service and cannot de- cline others’ requests. I probably overexaggerate things. I would rather win than lose in a game. I would rather do what I like alone than be with people. I often have headaches, nausea and hives. I am always modest. I have told that I am too honest. I am overly sympathetic to others. I am very selfish. I do not like everyone I know. I rather dislike being in the company of others. Changes in the weather or the environ- ment are apt to have a bad effect on my bodily condition. I am too irresolute. I am always the last to give up trying to do a thing. I am very serious and lack a sense of humor. I have an unyielding spirit. I have never been in love with anyone. I like reading books and appreciating nature by myself. The state of my health fluctuates and I always tznd to worry about it. I have often lost out on things because I couldn’t make up my mind soon enough. I am so methodic that I find it hard to set aside a task once I have under- taken it.

61) I don’t take things too seriously and

have an optimistic view of life. I always put on airs. I am not bothered when I am abused by someone before others. I am a person of few words and d o not mind having no friends. My sleep is disturbed and I am easily awakened. When I have to get up in front of peo- ple, my heart goes pitter-patter. I readily become so enthusiastic over a single thing that I sacrifice other things. I am a very good mixer. I tend to tire of the same thing and quickly want or become interested in new things. I sometimes gossip about people.

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