Iowa Scales of Personality Change

Parkinson's: (Houeto et al, 2001; n = 16; patients successfully treated by bilateral subthalamic stimulation, assessed by the patients spouse before and 6 months after surgery)

Changes in IRSPC scores in patients treated by continuous bilateral STN stimulation:

Test-Retest

 >10*

Test-Retest

<10*

Mean (SD)

Mean (SD)

Dimension

n = 8

n = 8

Irritability

-0.8 (2.0)

1.7 (1.4)

Lack of initiative

-2.8 (2.0)

2.6 (1.7)

Perseveration

-3.4 (1.8)

1.8 (1.3)

Depression

-2.9 (1.8)

1.3 (2.0)

Impulsivity

-0.5 (0.9)

1.2 (1.6)

Obsessiveness

0.5 (2.3)

-0.1 (1.8)

Lability/moodiness

0.0 (1.8)

1.1 (1.0)

Lack of persistence

-3.1 (2.0)

2.5 (1.5)

Lack of stamina

-2.4 (0.7)

1.0 (3.7)

Lack of planning

-2.0 (2.1)

2.4 (1.9)

Inflexibility

-1.1 (1.5)

1.4 (1.2)

Poor judgment

-1.0 (1.5)

1.3 (1.2)

Anxiety

-0.9 (1.0)

0.8 (3.0)

Insensitivity

-0.4 (1.1)

1.4 (0.9)

Social inappropriateness

-0.4 (1.1)

0.6 (1.4)

Dependency

-2.0 (2.1)

1.0 (1.9)

Impatience

-1.2 (2.1)

1.3 (1.0)

Type A behaviour

-0.9 (2.0)

-0.6 (1.4)

Blunted affect/unemotional

-0.6 (1.2)

0.6 (2.1)

Social withdrawal

-2.4 (2.4)

0.9 (2.0)

Aggression

-0.2 (0.7)

1.4 (1.6)

Indecisiveness

-0.7 (1.2)

1.6 (1.8)

Vanity

0.2 (0.7)

0.1 (1.1)

Suspiciousness

-0.1 (0.8)

1.2 (1.9)

Apathy

-1.9 (1.6)

2.0 (1.5)

Frugality

-0.1 (0.3)

-0.8 (2.6)

Inappropriate affect/emotion

-0.3 (0.7)

1.1 (1.6)

Manipulativeness

0.3 (0.7)

0.4 (0.5)

Vulnerability to pressure

-1.0 (1.1)

2.3 (1.6)

Lack of insight

-0.4 (1.1)

0.6 (1.4)

Total

-32.6 (16.8)

33.5 (14.1)

*Mean (SD)
BOLD = p < 0.05

No studies have been published assessing IRSPC norms with control subjects (Malloy and Grace 2005)

Bilateral Ventromedial Prefrontal Damage: (Barrash et al, 2000; n = 57; mean ages for the three groups ranged from 54 to 59 years; informants (close others) knew the patient, on average, more than 30 years)

IRSPC Ratings of Severity and Change:

Level Ratings

Change Ratings

Scale

PF–BVM

PF–NBVM

NPF

PF–BVM

PF–NBVM

NPF

Lack of insight

6.4 (1.0)

2.9 (1.5)

2.9 (1.6***)

2.4 (0.5)

0.3 (1.2)

0.1 (0.8***)

Lack of initiative

6.6 (0.8)

3.4 (1.7)

3.2 (1.4***)

2.6 (0.5)

1.0 (1.1)

0.5 (0.9***)

Irritability

6.1 (0.9)

4.4 (1.4)

3.7 (1.5***)

2.1 (0.4)

1.4 (1.0)

0.6 (0.9***)

Social inappropriateness

5.9 (1.5)

2.8 (1.1)

2.3 (1.4***)

2.4 (0.8)

0.4 (0.9)

0.2 (0.7***)

Poor judgment

6.3 (0.9)

3.6 (1.5)

3.2 (1.3***)

2.0 (1.4)

0.7 (0.8)

0.3 (0.7**)

Lack of persistence

5.4 (1.8)

3.4 (0.9)

2.6 (1.3***)

2.0 (1.1)

0.8 (0.9)

0.2 (0.7***)

Indecisiveness

6.0 (1.5)

3.0 (1.0)

3.6 (1.3***)

2.0 (1.0)

0.4 (0.9)

0.6 (0.9)

Lability

6.1 (1.2)

3.7 (1.5)

3.4 (1.4***)

2.3 (0.8)

0.9 (0.7)

0.6 (0.8***)

Blunted emotional experience

4.9 (1.5)

2.7 (1.5)

2.8 (1.1*)

1.6 (1.1)

–0.3 (0.7)

–0.3 (0.6***)

Apathy

4.9 (1.2)

3.6 (1.1)

3.3 (0.9*)

1.6 (1.0)

0.9 (0.9)

0.5 (0.8)

Inappropriate affect

5.1 (1.3)

2.9 (1.0)

2.8 (1.6**)

2.3 (0.8)

0.3 (0.6)

0.4 (0.7***)

Lack of planning

5.0 (2.3)

4.1 (1.3)

3.6 (1.3)

1.6 (1.4)

0.9 (1.1)

0.4 (0.9)

Poor frustration tolerance

5.0 (1.0)

4.5 (1.1)

3.4 (1.5**)

2.1 (0.9)

1.6 (0.8)

0.7 (1.0***)

Inflexibility

5.9 (1.2)

4.1 (1.3)

3.6 (1.5**)

2.0 (1.1)

0.7 (1.2)

0.4 (0.8*)

Behavioral rigidity

5.6 (2.1)

3.3 (1.3)

3.6 (1.4)

1.4 (1.5)

0.6 (0.9)

0.5 (0.7)

Low emotional expressivity

4.0 (1.7)

2.7 (1.4)

3.3 (1.6)

1.3 (1.6)

–0.3 (0.8)

–0.2 (0.8)

Insensitivity

5.3 (1.9)

3.7 (1.5)

2.9 (1.5)

1.4 (1.0)

0.1 (1.1)

0.2 (0.8*)

Excitability

 3.6 (1.9)

3.7 (1.3)

3.3 (1.3)

0.6 (1.3)

0.6 (1.3)

0.6 (0.9)

Anxiety

5.0 (2.0)

5.0 (2.0)

3.5 (1.5)

1.6 (1.5)

1.0 (0.9)

0.6 (0.7)

Impulsivity

3.9 (1.9)

3.5 (1.1)

2.8 (1.4)

1.1 (1.6)

0.6 (0.9)

0.2 (0.7)

Self-absorption

4.7 (1.9)

3.5 (1.3)

3.2 (1.2)

1.0 (1.1)

0.4 (0.9)

0.3 (0.6)

Obsessiveness

4.1 (2.2)

3.8 (1.3)

3.7 (1.4)

0.9 (1.9)

0.1 (1.0)

0.4 (0.7)

Social withdrawal

4.0 (2.4)

3.1 (1.3)

3.1 (1.4)

0.7 (1.4)

0.4 (0.7)

0.3 (0.8)

Disorganization

3.4 (2.4)

3.9 (1.0)

3.2 (1.5)

1.0 (1.7)

1.3 (1.0)

0.3 (0.9)

Manipulativeness

3.6 (2.2)

2.5 (1.0)

2.5 (1.3)

0.9 (1.2)

0.1 (0.7)

0.0 (0.3)

Dependency

3.7 (1.8)

2.9 (1.1)

3.4 (1.5)

1.0 (1.4)

0.9 (0.6)

0.6 (0.9)

Depression

3.9 (1.2)

3.5 (0.8)

3.4 (1.2)

1.3 (1.1)

0.8 (1.1)

0.6 (0.8)

Type A behavior

2.0 (1.7)

3.1 (1.7)

2.7 (1.3)

0.0 (1.4)

0.0 (1.2)

–0.3 (0.7)

Delusional thinking

2.9 (1.7)

1.9 (0.9)

2.2 (1.2)

0.9 (0.9)

0.3 (0.5)

0.1 (0.5)

Frugality

3.4 (2.8)

2.9 (1.1)

3.3 (1.1)

1.0 (1.3)

–0.1 (0.8)

0.3 (0.7)

PF–BVM = participants with prefrontal lesions with bilateral involvement of the ventromedial region

PF–NBVM = prefrontal lesions without bilateral involvement of the ventromedial region

NPF = non-prefrontal lesions

Convergent validity:

Brain Injury: (Barrash et al., 2022; n = 83, patients with ISPC ratings and available Minnesota Multiphasic Personality Inventory (MMPI) scores)

• Adequate convergent validity between Emotional/Social dimension of the ISPC and Behavioral/externalizing dysfunction scale (BXD) of the MMPI (r = 0.36, p < 0.001)
• Adequate convergent validity between Dysexecutive dimension of ISPC and the Emotional/internalizing dysfunction (EID) and BXD scales of the MMPI (r = 0.34 and 0.035, respectively, p < 0.001)
• Adequate convergent validity between Distressed dimension of ISPC and the EID scale of the MMPI (r = 0.38, p < 0.001)
• Poor convergent validity between Emotional/Social dimension of ISPC and Thought Dysfunction (THD) scale of the MMPI (r = 0.24, p < 0.05)
• Poor convergent validity between Hypoemotional dimension of ISPC and EID scale of the MMPI (r = 0.24, p < 0.05)
• Poor convergent validity between Distressed dimension of ISPC and BXD scale of the MMPI (r = 0.26, p < 0.05)

Brain Injury: (Barrash et al., 2022; n = 182, male = 96 (52.7%); mean age = 48.1 (14.4) years; interval of 5.2 (6.0) years (range = 4-360 months) between lesion acquisition and collection of personality data. patients with ISPC ratings and available Minnesota Multiphasic Personality Inventory (MMPI) scores)

Significant correlations between neuropsychological scores and personality disturbances1

Neuropsychological score

Dysexecutive (r)

Distress (r)

FSIQ

-0.221**

-1.99*

VCI

-0.067

-0.144

POI

-0.183*

-0.143

WMS Gen Mem

-0.336

-0.206*

AVLT-DR

-0.286***

-0.173*

TMT-B (seconds)2

0;374***

0.124

BDI-II

0.294***

0.338***

FSIQ = WAIS IV Full Scale IQ; VCI = WAIS IV Verbal Comprehension Index; POI = WAIS IV Perceptual-Organizational Index; WMS Gen Mem = Wechsler Memory Scales III General Memory Index; AVLT-DR = Auditory Verbal Learning Test-Delayed Recall; TMT-B = Trailmaking Test- Trail B; BDI-II = Beck Depression Inventory-II.

1Emotional/social disturbance and hypoemotional disturbance were not associated with cognitive performance.

2For the Trail Making Test- Trail B (seconds to completion), positive correlations indicate worse cognitive performance was related to increased personality disturbance. For the Beck Depression Inventory, positive correlations indicate higher levels of depression are related to increased personality disturbance.

* = p < 0.05, ** = p < 0.01, *** = p < 0.001

Bilateral Ventromedial Prefrontal Damage: (Barrash et al, 2000)

The IRSPC was shown to discriminate between patients with Prefrontal lesions with bilateral involvement of the ventromedial region, Prefrontal lesions without bilateral involvement of the ventromedial region and non-prefrontal lesions (refer to the "IRSPC Ratings of Severity and Change" Table in the "normative data" section of this summary for details"

Ventromedial Prefrontal Damage: (Barrash, et al. 1997; n = 115) 

• Factor analysis results suggest the IRSPC is composed of the following dimensions:
• Emotional functioning
• Behavioral control
• Social and interpersonal behavior
• Higher-order cognitive functions

Population Characteristics not Specified: (Barrash, et al 1997)

• Adequate agreement; Weighted Kappa, means: LEVEL = 0.48; CHANGE = 0.52 (correcting for chance agreement)