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Although the organic and psychosocial consequences of seizure disorders are thought to affect temperament and character patterns, these patterns in children with seizure disorders have not yet been investigated. We therefore investigated temperament and character patterns in Korean children with seizure disorders and their associations with seizure-related variables. The Korean version of the Junior Temperament and Character Inventory was used to assess temperament and character factors of 65 children with seizure disorders (32 boys, 33 girls; mean age, 10.6 +/- 1.8 years) and 65 healthy controls matched for age and sex. Children with seizure disorders showed higher harm avoidance, and lower persistence, self-directedness, and cooperativeness than controls. In children with seizure disorders, character factors such as self-directedness, cooperativeness, and self-transcendence were significantly associated with seizure type, and cooperativeness was correlated with seizure severity. Novelty seeking and self-directedness were correlated with paternal educational level and parental economic status, respectively. These findings suggest that children with seizure disorders have distinctive temperament and character patterns, with seizure type being the most influential factor modulating character patterns.

The ability to make precise distinctions among related personality constructs helps clarify theory and increases the utility of clinical assessment. In three studies, the authors evaluated the validity of distinctions among four impulsivity-like traits: sensation seeking, lack of planning, lack of persistence, and urgency (acting rashly when distressed). Factor analyses indicated that lack of planning and lack of persistence are two distinct facets of one broader trait, whereas urgency and sensation seeking are both very modestly related to each other and to the planning/persistence measures. The authors developed interview assessments of each, and multitrait, multimethod matrix results indicated clear convergent and discriminant validity among the constructs. The distinctions among them were useful: The traits accounted for different aspects of risky behaviors. Sensation seeking appeared to relate to the frequency of engaging in risky behaviors, and urgency appeared to relate to problem levels of involvement in those behaviors.

Objective: The aim of this study was to investigate temperament and character dimensions in a group of patients with nonspecific musculoskeletal disorders and to show how personality is related to pain and psychologic distress in pain patients., Method: A total of 78 patients with musculoskeletal disorders were compared with a matched control group of 118 nonpatients. The Temperament and Character Inventory, the Symptom Check List, and the Multidimensional Pain Inventory were used., Results: The pain patients differed significantly from the controls and exhibited a personality profile with high harm avoidance and low self-directness, which indicate that patients with nonspecific musculoskeletal pain disorders can be characterized as being cautious, insecure, and pessimistic. In addition, they can be described as having difficulties in accepting responsibility, lack of long-term goals, chronically low self-esteem, and struggle with identity. This is probably a salient characteristic of patients with chronic pain. The results also showed that personality dimensions had a stronger correlation to psychologic distress than to pain. The result indicated that harm avoidance probably is an important personality trait in anxiety states., Conclusions: The results underline the importance of using instruments assessing personality and psychologic symptoms in patients with nonspecific musculoskeletal disorders both as diagnostic tools and in treatment planning.

Objective: We investigated whether childhood temperament was able to predict carotid artery intima media thickness (IMT) and/or its risk factors in adulthood 21 years later., Methods: The subjects were the three youngest age cohorts of the population-based sample of the Cardiovascular Risk in Young Finns study, i.e., those who were aged 3 to 9 years (n = 708) at the baseline. IMT was assessed by ultrasound, and temperament in terms of negative emotionality, hyperactivity, and sociability (following Buss and Plomin). In addition, the levels of traditional risk factors for atherosclerosis were measured in both childhood and adulthood., Results: Childhood temperament was found to predict adulthood risk factors such as smoking in both genders and body mass index (BMI), systolic blood pressure (SBP), and educational level in women. In women, childhood hyperactivity predicted adulthood IMT after adjustment for childhood and adulthood risk factors for atherosclerosis., Conclusion: These findings suggest that temperament may contribute to the development of IMT in two ways: indirectly through risk factors in both genders and in women directly through a mechanism that is not considered in the present study. There were no significant gender-related differences in temperament, but it seemed to play different roles in different genders. Hyperactivity was a greater risk for girls than for boys.

Purpose: The purpose of this study was to determine if a relationship existed between a mother's perception of her child's temperament and the child's risk factors for early childhood caries (ECC)., Methods: Data was collected from 629 records of children ages 0 to 4 who were patients of the University of Iowa's Infant Oral Health Program. Data included: (1) maternal report of child's temperament; (2) knowledge of ECC; (3) dietary and oral hygiene habits; and (4) clinical evidence of cavitated and noncavitated lesions and visible plaque on maxillary incisors. Chi-square tests and logistic regression models were used to analyze the data., Results: Bivariate analyses showed that children reported as "easy" were more likely to: (1) be younger (P=.001); (2) be breast-fed to sleep (P=.046); (3) be breast-fed throughout the night (P=.012); and (4) have their teeth brushed twice daily (P=.006). Children reported as "difficult" were more likely to: (1) be bottle-fed to sleep (P=.002); and (2) have noncavitated lesions (P=.044). Final logistic regression analysis indicated that children perceived as "easy" were more likely to breast-fed throughout the night (odds ratio [OR]= 1.77; P=.016), while those perceived as "difficult" were more likely to be bottle-fed to sleep (OR=1.74; P=.016)., Conclusions: Maternal reported child temperament may be related to important early childhood caries risk factors.

The transition to parenthood is often accompanied by depression and stress. Several studies have established risk factors for postpartum depression, e.g., antenatal depression. However, only a few studies have involved fathers. Moreover, most studies focus on the prevalence of depression instead of intraindividual changes over time. Our study investigated differential effects of parental psychopathology and child difficulty on the course of depressive symptoms and feelings of stress for first-time mothers and fathers. Seventy-four mothers and 58 fathers completed questionnaires on depressive symptoms (EPDS) and feelings of stress during pregnancy, and at 1, 3, 12, and 18 months postpartum. Parents rated children's difficulty-fussiness at 3, 12, and 18 months postpartum (ICQ). Parental psychopathology was established during pregnancy using self-reports (SCL-90-R) and anamnestic data. In mentally healthy mothers and fathers depressive symptoms decreased from pregnancy to 18 months postpartum, whereas parents with psychopathology in pregnancy showed a tendency to prolonged depressive phases. In parents with psychopathology, feelings of stress peaked at 12 months postpartum. Child difficulty was associated with elevated levels of psychosocial stress, but only for some participants. Parental psychopathological symptoms during pregnancy should thus be considered as a risk factor for elevated and prolonged depression and elevated psychosocial stress in mothers and fathers across the transition to parenthood.

Objective: This study was designed to investigate the link among attention deficit hyperactivity disorder (ADHD) in adults, novelty-seeking temperament, and the 48-base pair (bp) dopamine D4 receptor (DRD4) gene variant., Method: This study drew from a larger molecular genetic study of ADHD in which the ascertainment criterion was having an affected sibling pair with ADHD. Parents (N=171) from 96 families provided data. Of the 171 parents, 56 (33%) had a lifetime history of ADHD, with 28 (50%) continuing to meet DSM-IV criteria (i.e., "persistent" ADHD). Latent variable modeling was used to test whether the DRD4 gene variant or Temperament and Character Inventory factors could predict ADHD., Results: Using latent variable modeling, the authors were able to confirm the first-order factor structure of the Temperament and Character Inventory. Furthermore, novelty seeking predicted ADHD lifetime diagnosis (R(2)=26%), while the DRD4 gene variant independently predicted ADHD (R(2)=5%) but not novelty seeking., Conclusions: In this unique sample of parents from multiply affected ADHD families, novelty seeking and the 48-bp DRD4 variant were associated with a lifetime history of ADHD. However, the association between novelty seeking and ADHD does not appear to be due to variation in the 48-bp DRD4 variant.

Background: Certain sexual behaviors and abuse of substances contribute to the risk of becoming HIV-infected. Because dispositional characteristics are likely to influence this process, we examined the association between temperament and HIV serostatus in subjects with heavy use of drugs and various sexual risk behaviors., Methods: Two hundred and thirty individuals (81% of whom were HIV-infected) were assessed for underlying temperamental characteristics, substance use, and risky sexual behaviors. Toward this goal, a factor analysis was conducted on a new self-rated Temperament Autoquestionnaire (Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A)). MANOVA was used to examine overall associations between risky behaviors and temperament. Additionally, directed MANOVAs were conducted for each of six drugs of abuse (alcohol, marijuana, cocaine, opioids, other stimulants, and sedative hypnotics)., Results: Factor analysis confirmed the hypothesized temperament structure of five distinct factors: Cyclothymic, hyperthymic, anxious, irritable-explosive, and depressive. Heavy users of cocaine, other stimulants, and alcohol were more likely to have an irritable-explosive temperament. Interestingly, heavy users of opioids were more likely to show depressive and hyperthymic traits. The inclusion of HIV status as a predictor of temperament did not alter the results. Unlike a previous study, no direct significant relationships were found between risky sexual behaviors and specific temperaments., Limitations: Relatively small sample size for a factor analytic study, and cross-sectional design, which cannot determine a cause and effect relationship., Conclusions: We succeeded in studying and validating five distinct affective temperaments in a substance abuse population. Irritable-explosive, and to a lesser extent, depressive and hyperthymic traits, were associated with substance use, and may place individuals at risk for HIV infection via that mechanism. That current risky sexual practices were not directly linked to temperament may reflect modification in sexual behavior following the acquisition of HIV disease.

Background: The purpose of the study was to evaluate the psychometric properties of the German version of the TEMPS-A questionnaire. Besides the reliability of the temperament scales, validity was the focus of interest. Therefore, the relationship between the TEMPS-A and the well-established personality questionnaire NEO-FFI, whose factors show theoretical overlap with temperaments, was investigated., Method: A total of 227 students aged between 20 and 42 years were asked to fill in both instruments. Reliability coefficients for the five temperament scales and correlations among the scales of both questionnaires were calculated, as well as multiple linear regression analysis with the five personality factors and gender as independent, and the five temperaments as dependent variables., Results: Reliability indices for the five temperament scales were satisfactory, with values ranging between 0.63 (depressive) and 0.76 (anxious). Women scored higher on depressive and anxious scales, whereas men had higher scores on hyperthymic temperament. Correlations within the temperament scales showed close relationships between depressive, anxious and cyclothymic temperaments; cyclothymic and irritable temperament were also related. The personality factors of the NEO-FFI predicted temperaments fairly well and explained between 41% and 58% of the variance; the main effects were exerted by neuroticism and extraversion, while the irritable temperament was primarily explained by low agreeableness., Limitation: The study sample was relatively small and selected., Conclusion: The TEMPS-A scale has sufficient reliability and good validity in a non-clinical sample. It opens new possibilities for clinical research at the interface of mental disorders, temperament and personality. Such research is in progress.

Background: Stimulant abuse and dependence in confusing admixtures with features of bipolar disorder has been variously conceptualized. DSM-IV-TR rules tend to be liberal in permitting the diagnosis of substance-induced disorder, and rather strict for a bipolar diagnosis in such cases. Accordingly, if bipolarity is ever considered in this interface, it usually pertains to syndromal bipolar I disorder., Method: We therefore focused on the more prevalent but relatively neglected admixture of stimulant abuse with bipolar II and lesser degrees of bipolarity. We examined in our dual diagnosis program the longitudinal progression of the dual pathology in 10 patients who had proven refractory to past efforts to treat the stimulant component. In doing so, we wished to better delineate the nature of the clinical interface of the stimulant bipolar spectrum and its response to anticonvulsant mood stabilizers., Results: In nearly all cases cyclothymic and hyperthymic traits preceded the use of stimulants by years, which seemed to serve the purpose of controlling or maintaining the subthreshold rewarding mood condition. Eventually clinically more ominous and socially destructive pathology evolved, with contributions from both the bipolar diathesis and the addictive process. Seven of 10 cases had bipolar familial indicators. Nearly all evidenced hypomanic and/or irritable depressive states with mixed features during protracted sobriety from the stimulant. Except for two of the 10 patients, substantial (30-45 point) gains were made on DSM-IV-TR axis V general assessment of functioning (GAF) scores with the use of largely "mood-stabilizing" anticonvulsants. This was paralleled with the reduction of craving. These data highlight the human dimensions of the bipolar-stimulant abuse interface, and document functional outcomes (rather than mere changes in rating scales which may not necessarily reflect clinically relevant improvement)., Limitation: Open case series of 10 patients., Conclusion: We propose a bipolar-stimulant spectrum-what the senior author has elsewhere labeled bipolar III-1/2-where subthreshold bipolar traits are complicated by stimulant abuse, eventually leading to pathology characteristic of both disorders. The contribution of bipolarity to this spectrum is supported by: (1) premorbid cyclothymic and hyperthymic traits; (2) familial bipolarity; (3) presence of subthreshold bipolar signs and symptoms during protracted sobriety. We further submit that anticonvulsants in this spectrum not only treat the acute escalation of activated and mixed depressive states, withdrawal phenomena, and craving for the stimulant, but also the craving for activation and mood enhancement of the underlying temperament. We submit that the latter might be crucial for the successful attenuation of the underlying diathesis for stimulant seeking behavior, abuse and dependence.

Objective: Understanding of mood disorders can be enhanced through assessment of temperamental traits. We explored temperamental commonalities and differences among euthymic bipolar (BP) and unipolar (MDD) mood disorder patients, creative discipline graduate student controls (CC), and healthy controls (HC)., Methods: Forty-nine BP, 25 MDD, 32 CC, and 47 HC completed self-report temperament/personality measures including: The Affective Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A); the Revised NEO Personality Inventory (NEO-PI-R); and the Temperament and Character Inventory (TCI)., Results: Euthymic BP, MDD, and CC, compared to HC, had significantly increased cyclothymia, dysthymia and irritability scores on TEMPS-A; increased neuroticism and decreased conscientiousness on NEO-PI-R; and increased harm avoidance and novelty seeking as well as decreased self-directedness on TCI. TEMPS-A cyclothymia scores were significantly higher in BP than in MDD. NEO-PI-R openness was increased in BP and CC, compared to HC, and in CC compared to MDD. TCI self-transcendence scores in BP were significantly higher than in MDD, CC, and HC., Limitations: Most of the subjects were not professional artists, and represented many fields; temperament might be different in different art fields., Conclusions: Euthymic BP, MDD, and CC compared to HC, had prominent temperamental commonalities. However, BP and CC had the additional commonality of increased openness compared to HC. BP had particularly high Cyclothymia scores that were significantly higher then those of MDD. The prominent BP-CC overlap suggests underlying neurobiological commonalities between people with mood disorders and individuals involved in creative disciplines, consistent with the notion of a temperamental contribution to enhanced creativity in individuals with bipolar disorders.

Background: One of the major objectives of the French National EPIDEP Study was to show the feasibility of systematic assessment of bipolar II (BP-II) disorder and beyond. In this report we focus on the utility of the affective temperament scales (ATS) in delineating this spectrum in its clinical as well as socially desirable expressions., Methods: Forty-two psychiatrists working in 15 sites in four regions of France made semi-structured diagnoses based on DSM IV criteria in a sample of 452 consecutive major depressive episode (MDE) patients (from which bipolar I had been removed). At least 1 month after entry into the study (when the acute depressive phase had abated), they assessed affective temperaments by using a French version of the precursor of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS). Principal component analyses (PCA) were conducted on hyperthymic (HYP-T), depressive (DEP-T) and cyclothymic (CYC-T) temperament subscales as assessed by clinicians, and on a self-rated cyclothymic temperament (CYC-TSR). Scores on each of the temperament subscales were compared in unipolar (UP) major depressive disorder versus BP-II patients, and in the entire sample subdivided on the basis of family history of bipolarity., Results: PCAs showed the presence of a global major factor for each clinician-rated subscale with respective eigenvalues of the correlation matrices as follows: 7.1 for HYP-T, 6.0 for DEP-T, and 4.7 for CYC-T. Likewise, on the self-rated CYC-TSR, the PCA revealed one global factor (with an eigenvalue of 6.6). Each of these factors represented a melange of both affect-laden and adaptive traits. The scores obtained on clinician and self-ratings of CYC-T were highly correlated (r=0.71). The scores of HYP-T and CYC-T were significantly higher in the BP-II group, and DEP-T in the UP group (P<0.001). Finally, CYC-T scores were significantly higher in patients with a family history of bipolarity., Conclusion: These data uphold the validity of the affective temperaments under investigation in terms of face, construct, clinical and family history validity. Despite uniformity of depressive severity at entry into the EPIDEP study, significant differences on ATS assessment were observed between UP and BP-II patients in this large national cohort. Self-rating of cyclothymia proved reliable. Adding the affective temperaments-in particular, the cyclothymic-to conventional assessment methods of depression, a more enriched portrait of mood disorders emerges. More provocatively, our data reveal socially positive traits in clinically recovering patients with mood disorders.

Background: The array of different diagnoses and clinical presentations seen in the family members of bipolar probands suggests a quantitative or spectrum phenotype. Consistent with this idea, it has been proposed that an underlying quantitative variation in temperament may be the primary phenotype that is genetically transmitted and that it in turn predisposes to bipolar disorder (BP). Choosing the appropriate phenotypic model for BP is crucial for success in genetic mapping studies. To test this theory, various measures of temperament were examined in the family members of bipolar probands. We predicted that a gradient of scores would be observed from those with BP to those with major depression to unaffected relatives to controls., Methods: Members of 85 bipolar families and 63 control subjects were administered clinical interviews for diagnosis (SCID) and two temperament assessments, the TEMPS-A and TCI-125. Subjects with BP, major depressive disorder, unaffected relatives, and controls were compared on each temperament scale and on eight factors extracted from a joint factor analysis of the TEMPS-A and TCI-125., Results: The four groups were found to be significantly different and with the expected order of average group scores for four of the TEMPS-A scales, three of the TCI-125 scales, and one of the extracted factors. On the fifth TEMPS-A scale, hyperthymic, controls scored higher than the other three subject groups contrary to expectations. Significant differences were seen between unaffected relatives and controls on the hyperthymic scale and on the first extracted factor, anxious/reactive., Limitations: Controls were mainly recruited through advertisements, which may have introduced an ascertainment bias. It is also possible that mood state at the time of completing the questionnaire influenced subject's rating of their temperament. Additionally, bipolar I and bipolar II subjects were placed in the same group even though they had some differing clinical features., Conclusions: Our data support the theory that some dimensions of temperament are transmitted in families as quantitative traits that are part of a broader bipolar spectrum. In particular, the hyperthymic scale of the TEMPS-A and the anxious/reactive extracted factor distinguished unaffected relatives from controls. The hyperthymic scale yielded results opposite to expectation with controls higher than any family group. This may be an artifact of the self-rated form of the questionnaire, a consequence of our grouping bipolar I and II subjects together, or the result of a "protective" factor and bears further study. Nevertheless, both of these scales may be useful quantitative traits for genetic mapping studies.

Background: Although generalized anxiety disorder (GAD) is currently described as a time-limited state mental disorder, emerging evidence suggests that it is best considered as an exaggeration of a putative "anxious temperament" (AT). It is presently unknown whether it is a distinct or unitary construct of a melange of anxious traits related to Cluster-C personality disorders., Methods: As part of a Franco-American collaborative study, we developed the 15-item Operational Criteria for Anxious Personality (OCAP), expanding criteria sets developed earlier by one of us (H.S.A.). The study, which was conducted in the French primary care medical sector, included 1112 young adults (18-40 years), seeking help for isolated anxious complaints, never treated before-and without any diagnosable disorder on the axis I of DSM-IV. As previous papers have reported the preliminary validity of OCAP, especially concurrent validity with the State-Trait Anxiety Inventory (STAI) (Speilberger), in this report, we focus on its full psychometric properties., Results: The present data indicate a normal distribution of AT items, a satisfactory Chronbach's coefficient (0.64), and the presence at intake of three different subtypes of AT: "anxious-avoidant," "anxious-phobic," and "anxious-sensitive." After a prospective 6-month follow-up, the major criteria of AT were stable in 80% of cases, and for specific AT items, the stability rate varied between 65% and 80%; much of the unstable items were accounted by improvement during naturalistic treatment. The latter could explain the different factor structure obtained at follow-up, which tended to be less heterogeneous, and represented by one global factor., Limitation: We used a categorical (yes/no) rather than a Likert-type gradation of frequency and intensity of anxiousness items and relatively low number of items, especially for those involving worrying about one's own health or that of one's loved ones., Conclusions: Anxiousness as a temperamental dimension appears to involve putative subtypes along "worrying," "phobic," "sensitive" (and "avoidant") dimensions.

Objective: To validate a short English-language version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire version (TEMPS-A), a self-report questionnaire designed to measure temperamental variations in psychiatric patients and healthy volunteers. Its constituent subscales and items were formulated on the basis of the diagnostic criteria for affective temperaments (cyclothymic, dysthymic, irritable, hyperthymic, and anxious), originally developed by the first author and his former collaborators. Further item wording and selection were achieved at a later stage through an iterative process that incorporated feedback from clinicians, researchers, and research volunteers., Method: A total of 510 volunteers (284 patients with mood disorders, 131 relatives of bipolar probands, and 95 normal controls) were recruited by advertisement in the newspapers, announcements on radio and television, flyers and newsletters, and word of mouth. All participants were interviewed using the Structured Clinical Interview for DSM-III-R, and completed the 110-item TEMPS-A and the Temperament and Character Inventory (TCI-125). The factorial structure, the alpha coefficients, and the item-total correlations coefficients of the TEMPS-A and the correlation coefficients between the dimensions of the TCI and the TEMPS-A subscales were then determined., Results: A principal components analysis with a Varimax rotation found that 39 out of the 110 original items of the TEMPS-A loaded on five factors that were interpreted as representing the cyclothymic, depressive, irritable, hyperthymic, and anxious factors. Coefficients alpha for internal consistency were 0.91 (cyclothymic), 0.81 (depressive), 0.77 (irritable), 0.76 (hyperthymic), and 0.67 (anxious) subscales. We found statistically significant positive correlations between all-but the hyperthymic-subscales and harm avoidance. Positive correlations with the hyperthymic and cyclothymic, and novelty seeking and negative correlations with the remaining subscales were also recorded. Other major findings included positive correlations between the hyperthymic and reward dependence, persistence and self-directedness; positive correlation between the self-transcendence and the cyclothymic, hyperthymic and the anxious; and negative correlations between the depressive, cyclothymic, irritable, anxious and cooperativeness., Limitation: As the full-scale anxious temperament was added after the four scales of the TEMPS-A were developed, it has only been evaluated in 345 subjects., Conclusions: These data indicate that the TEMPS-A in its shortened version is a psychometrically valid scale with good internal consistency. The proposed five subscale structure is upheld. Concurrent validity against the TCI is shown. Most importantly, for each of the temperaments, we were able to show positive attributes which are meaningful in an evolutionary context, along with traits which make a person vulnerable to mood shifts. This hypothesized dual nature of temperament, which is upheld by our data, is a desirable characteristic for a putative behavioral endophenotype in an oligogenic model of inheritance for bipolar disorder.

We sketch out putative evolutionary roles for affective temperaments within the theoretical framework of mood disorders conceptualized as extremes in an oligogenic model of inheritance, whereby the constituent traits in their dilute phenotypes confer adaptive advantages to individuals and/or their social group. Depressive traits, among other functions, would subserve sensitivity to the suffering of other members of the species, overlapping with those of the generalized anxious temperament, thereby enhancing the survival of not only kin but also other conspecifics. The pursuit of romantic opportunities in cyclothymia suggests that it may have evolved as a mechanism in reproductive success; cyclothymics' creative bent in poetry, music, painting, cooking or fashion design (among men, in particular) also appears useful for sexual seduction. Hyperthymic traits would lend distinct advantages in leadership, exploration, territoriality and mating. These are just some of the possibilities of the rich and complex temperamental traits subserving bipolarity within an evolutionary framework. We test selected aspects of these hypotheses with the use of correlations between the constituent traits of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS) and correlations between the TEMPS and the Temperament and Character Inventory (TCI). Such data support the counterbalancing protective influence of harm avoidance on the risk-taking behavior of cyclothymic individuals, in both men and women. Finally, we outline a hypothesis on the evolutionary function of anxious-depressive traits for women.

Introduction: Although several recent studies suggest that bipolar disorder most commonly begins during childhood or adolescence, the illness still remains under-recognized and under-diagnosed in this age group. As part of the French Bipolar network and in line with the hypothesis that juvenile depression is pre-bipolar , we evaluated the rate of onset of bipolar disorders in a naturalistic 2-year prospective study of consecutive, clinically depressed children and adolescents, and to test whether the cyclothymic temperament underlies such onset., Methods: Complete information was obtained from both parents and patients in 80 of 109 depressed children and adolescents assessed with Kiddie-SADS semi-structured interview, according to DSM IV criteria. They were also assessed with a new questionnaire on cyclothymic-hypersensitive temperament (CHT) from the TEMPS-A cyclothymic scale adapted for children (provided in ), and other assessment tools including the Child Depression Inventory (CDI), Young Mania Rating Scale, Clinical Global Assessment Scale (CGAS), and Overt Aggressive Scale (OAS)., Results: Of the 80 subjects, 35 (43%) could be diagnosed as bipolar at the end of the prospective follow-up. This outcome was significantly more common in those with cyclothymic temperament measured at baseline. Most of these patients were suffering from a special form of bipolar disorder, characterized by rapid mood shifts with associated conduct disorders (CD), aggressiveness, psychotic symptoms and suicidality., Limitation: The primary investigator, who took care of the patients clinically, was not blind to the clinical and psychometric data collected. Since all information was collected in a systematic fashion, the likelihood of biasing the results was minimal., Conclusion: We submit that the CHT in depressed children and adolescents heralds bipolar transformation. Unlike hypomanic or manic symptoms, which are often difficult to establish in young patients examined in cross-section or by history, cyclothymic traits are detectable in childhood. Our data underscore the need for greater effort to standardize the diagnosis and treatment of pre-bipolar depressions in juvenile patients.

Objective: The identification of specific temperament dimensions as correlates or risk factors for psychopathology in infancy, childhood and adolescence might provide key information to elucidate causal mechanisms that underlie these relationships., Methods: A non-clinical sample of 1010 students (518 males and 492 females) without major psychiatric disorders was given psychometric assessment using TEMPS-I (the Italian Semi-structured Interview version of the Temperament Evaluation of Memphis, Pisa, and San Diego) and EBC (Emotional and Behavioral Checklist in Infancy, Childhood and Adolescence). Grouping the subjects on the basis of the highest z-score obtained on each of the four temperament scales of TEMPS-I, it was possible to identify the dominant affective temperamental (AT) inclination of each individual: 283 (28.0%) subjects were classified as dominant depressive temperament, 446 (44.2%) as dominant hyperthymic, 221 (21.9%) as dominant cyclothymic, and 60 (5.9%) as dominant irritable. The effects of AT dominant groups on EBC scores were tested by one-way analysis of variance. To control for age and sex effects, we tested the differences within dominant AT groups by a multiple classification analysis (MCA)., Results: As expected, subjects with depressive temperament traits were characterized by social inhibition and lack of antisocial and hyperactive behavior. Cyclothymic subjects reported the highest number of emotional and behavioral problems, compared with the other dominant ATs (depressive, hyperthymic and irritable). In particular, a cyclothymic disposition was most frequently associated with anxiety-sleep disturbances, sensitivity to separation, eating disturbances in females and antisocial-aggressive behavior in males. The relationship between cyclothymic temperament and anxiety-sleep disturbances and antisocial-aggressive behavior increased with age., Limitations: Cross-sectional study based on retrospective evaluation., Conclusions: Within a juvenile population, depressive temperament is a construct partially overlapping with behavioral inhibition, while extremes of emotionality and behaviors occur preponderantly in those with cyclothymic traits. The cyclothymic disposition turned out to be the most 'morbid', and associated with both internalizing and externalizing disturbances.

Background: The aims of this study were to identify the dominant affective temperamental characteristics of patients with bipolar disorder (BP) and their clinically well first-degree relatives and to compare the prevalence rates of these temperaments with those in healthy control subjects., Methods: One hundred bipolar I probands and their 219 unaffected first-degree relatives were enrolled in the study. The control group consisted of healthy subjects without any personal or family history of bipolar disorder, matched with the age and gender of the probands and first-degree relatives. To identify the dominant affective temperaments, the Turkish version of TEMPS-A scale was used., Results: At least one dominant temperament was found in 26% of the proband group, in 21.9% of the relative group, and 6.0% and 10.0% of the control groups, respectively. The most noteworthy finding was that both the probands and their relatives had significantly higher frequency of hyperthymic temperament than the controls., Limitations: Temperament had not been assessed premorbidly in the probands with bipolar disorder., Conclusions: The study supports the familial, possibly genetic, basis for the hyperthymic temperament in the genesis of bipolar I dosorder. That the cyclothymic temperament was not similarly represented, may be due to the higher specificity of the cyclothymic temperament to the bipolar II sybtype (which we did not study). More research is needed on the relevance of cyclothymic and other temperaments to the genetics of bipolar disorders selected by rigorous subtyping along the clinical spectrum of bipolarity.

Background: In Japan, Kraepelin's descriptions on four "fundamental states" of manic depressive illness, the concepts of schizoid temperament by Kretschmer and obsessional and melancholic type temperament by Shimoda and Tellenbach have been widely accepted. This research investigates the construct validity of these temperaments through factor analysis., Method: TEMPS-A measured depressive, cyclothymic, hyperthymic and irritable temperaments and MPT rigidity, esoteric and isolation subscales measured, respectively, melancholic type and schizoid temperaments. Factor analysis was implemented with TEMPS-A alone and TEMPS-A and MPT combined data., Results: With TEMPS-A alone analysis, Factor 1 included 1 depressive, 11 cyclothymic and 12 irritable temperament items with a factor loading higher than 0.4; Factor 2 included 1 depressive and 10 hyperthymic temperament items; and Factor 3 included 2 depressive temperament items only. With TEMPS-A and MPT combined data, Factor 1 included 3 depressive, 11 cyclothymic and 5 irritable temperament items with a factor loading higher than 0.4 (interpreted as the central cyclothymic tendency for all affective temperaments along Kretschmerian lines and accounting for 11.7% of the variance); Factor 2 included 6 hyperthymic temperament items (6.22% of variance); Factor 3 included 1 cyclothymic, 7 irritable and 1 schizoid temperament items (interpreted as the irritable temperament and accounting for 3.24% of the variance); Factor 4 included 1 depressive temperament and 5 melancholic type items (interpreted as the latter, accounting for 2.66% of the variance); Factor 5 included 5 depressive temperament items, along interpersonal sensitivity and passivity lines, and accounting for 2.31% of the variance; and Factor 6 included 4 schizoid temperament items accounting for 2.07% of the variance., Limitation: We did not use the Kasahara scale, which some believe to better capture the Japanese melancholic type. Sample was 70% male., Conclusion: These analyses confirm the factor validity of depressive, hyperthymic, cyclothymic and irritable temperaments (TEMPS-A), as well as the melancholic type and the schizoid temperament (MPT). Traits of the depressive and melancholic types emerge as rather distinct. Indeed, our results permit the delineation of an interpersonally sensitive type that "gives in to others" as the core features of the depressive temperament; this is to be contrasted with the higher functioning, perfectionistic, work-oriented melancholic type. Mood dysregulation is represented by the largest number of traits in this population. Contrary to a widely held belief that the melancholic type with its devotion to work and to others is the signature temperament in Japan, cyclothymic traits account for the largest variance in this nonclinical population. Hyperthymic temperament, melancholic type and schizoid temperaments appear largely independent of mood dysregulation. In this Japanese population, TEMPS-A may identify temperament constructs more comprehensively when implemented with melancholic type and schizoid temperament question items added to it. The proposed new Japanese Temperament and Personality (JTP) Scale has self-rated items divided into six subscales.

Background: The modern concept of affective disorders focuses increasingly on the study of subthreshold conditions on the border of manic or depressive episodes. Indeed, a spectrum of affective conditions spanning from temperament to clinical episodes has been proposed by the senior author. As bipolar disorder is a familial illness, an examination of cyclothymic temperament (CT) in controls and relatives of bipolar patients is of major relevance., Methods: We recruited a total sample of 177 healthy symptom-free volunteers. These controls were divided into three groups. The first one is comprised of 100 normal subjects with a negative familial affective history (NFH); the second of 37 individuals, with positive affective family history (PFH); and a third of 40 subjects, with at least one sib or first-degree kin with bipolar disorder type I according to the DSM-IV (BPR). The last two groups defined at risk individuals. We interviewed all subjects with CT, as described by the senior author., Results: We found a statistically significant difference in the rates of CT between the subjects in BPR versus others. CT was also more prevalent in the PFH compared with NFH. Additionally, the simple numeration of the CT traits exhibited gradation in the distribution of individuals inside the NFH, PFH and BPR. Finally, categorically defined CT and CT traits predominated in females. LIMITATION and, Conclusion: Although not all relatives of bipolar probands were studied, our results exhibit an aggregation of CT in families with affective disorder-and more specifically those with bipolar background. These results allow us to propose the importance of including CT for phenotypic characterization of bipolar disorder. Furthermore, our results support a spectrum concept of bipolar disorder, whereby CT is distributed in ascending order in the well-relatives of those with depressive and bipolar disorders. We submit that this temperament represents a behavioral endophenotype, serving as a link between molecular and behavioral genetics.

Background: With the possible exception of cyclothymia in artists, there is a paucity of data in the literature on the temperament in different professions., Methods: For this exploratory study, we sought to generate preliminary data on temperaments among psychiatric outpatients, including physicians (n=41), lawyers (n=30), managers and executives (n=35), industrialists (n=48), architects (n=27), journalists (n=34), and a mixed group of artists (n=48). They were compared with age, sex, social class, and affective disorder matched outpatients outside of these professions, drawn from the same clinical settings to serve as our Comparison Group (CG, n=120). We used an interview version of the Akiskal-Mallya criteria for temperaments. We finally used the DSM-III-R obsessive compulsive personality (OC traits)., Results: Compared with the CG, lawyers and physicians had high rates of dysthymic temperament and OC traits. Managers, like lawyers and doctors, had high rates on OC traits but were different in being very low on cyclothymic and twice as hyperthymic than the CG was. Industrialists, who, by definition, were self-made, had even higher rates of hyperthymic traits. Both architects and artists seemed to have benefited from being cyclothymic (3-4 times higher than CG's); interestingly, architects had higher levels of OC traits, and artists were less obsessional than the CG was. Overall, among managers/executives and lawyers, 41% met criteria for affective temperaments, whereas the equivalent rate among the remainder was 77%., Limitation: Given that this is a chart review of existing clinical records, it was not possible to be blind to the profession of the patients. A mixed group of artists may have obscured differences among artists from different domains of art (e.g., poets vs. performing artists), and the same can be said of physicians (e.g., internists vs. surgeons). A disclaimer would be appropriate: Ours is not a study on eminence in the different professions but on the temperament and personality profiles that distinguish among them., Conclusions: Despite the foregoing limitations and overlapping attributes in the different professions, they nonetheless emerged as having distinct temperamental and personality profiles. Dysthymic and obsessional attributes are notable in lawyers and physicians. We confirm the role of cyclothymia in artists and architects. The role of the hyperthymic temperament in managers, self-made industrialists, and journalists, to the best of our knowledge, is being reported for the first time. The role of cyclothymic and hyperthymic temperaments appears to be moderated by obsessional traits across the entire professional realm examined. In particular, artists' creative imagination appears "liberated" by low levels of OC traits, whereas among architects, relatively high levels of OC traits seem to contribute to the execution of their work. More tentatively, judging from the overall levels of affective temperaments in the remaining professions, on average, more of the managers/executives than self-made industrialists could be described as "colder" in temperament, and more of the physicians "warmer" than lawyers are. Journalists, as a group, appeared to possess the broadest representation of affective temperaments. The foregoing conclusions must be regarded as tentative, even hypothetical, in need of verification among professionals without major psychiatric disorders. Nonetheless, temperament profiles among psychiatrically ill professionals in the seven professional realms studies can help predict how they relate to their doctors, family members, colleagues, coworkers, and clients/patients. Such knowledge, in turn, can help the therapeutic process.

Our aim was to examine the relationship between personality dimensions and hypochondriacal concerns and somatic symptoms in a military population. The Schedule of Nonadaptive and Adaptive Personality along with measures of hypochondriacal concerns and somatic symptoms were administered to 602 military veterans who had been on active duty during the 1991 Gulf War. Factor analyses identified six separable dimensions-two of hypochondriacal concerns, two of somatic symptoms, and two of possible mechanisms of symptom generation-for study. Multiple regression models determined the proportion of variation in these measures of somatic distress explained by personality scales. Personality measures explained between 26% and 38% of the variance in hypochondriacal concerns and somatic symptoms, and Negative Temperament accounted for most of this. Moderately strong positive correlations were observed between trait scales Mistrust, Low Self-Esteem, and Eccentric Perceptions and the various measures of somatic distress. Thus, when Negative Temperament was taken into account, few significant correlations between personality measures and hypochondriacal concerns or somatic symptoms remained. Negative temperament or neuroticism is strongly associated with hypochondriacal concerns. Important features of hypochondriasis and somatic distress appear to lie within the domain of personality. It remains for future research to show whether negative temperament is a vulnerability factor for hypochondriasis or hypochondriasis is itself a personality disorder.

Currently, in the UK military, and particularly in the Army, a significant number of personnel are regularly discharged on the grounds of being assessed as "Temperamentally Unsuitable (TU) for military duties", under Queen's Regulations (QRs): (Army) 9.414 and 9.434 (1). In the last two years (2001--2003), preliminary figures suggest that approximately 700 serving personnel were recommended for discharge under this category by only four psychiatrists in the south of England. The regulations governing TU have been in existence and essentially unchanged since their development long before the 1960s albeit subject to parliamentary quinquennial review. The Army General and Administrative Instructions (AGAI) (2) standards also remain unchanged over this period. This paper raises questions about the current validity and relevance of existing TU concepts and regulations with suggestions as to what is being proposed in the context of changing roles, technology and advances in the modern armed forces.

Objective: The authors examined the capacity of alexithymia to predict a broad range of psychiatric symptoms relative to that of other personality dimensions, age, and gender., Method: The Toronto Alexithymia Scale, the Temperament and Character Inventory, and the SCL-90-R were administered to 254 psychiatric patients. Multivariate linear regression analyses were performed., Results: The difficulties identifying feelings factor of the Toronto Alexithymia Scale significantly predicted all SCL-90-R subscale scores and was particularly effective, relative to the personality dimensions of the Temperament and Character Inventory, in predicting somatization. The Temperament and Character Inventory dimensions emerged as distinct and conceptually meaningful predictors for the different SCL-90-R subscales., Conclusions: A broad range of current psychopathology is associated with difficulties in cognitively processing emotional perceptions. Further research needs to clarify whether alexithymia represents a risk factor for mental illness and poorer outcome.

Objective: This study examined the extent to which individuals with a lifetime diagnosis of recurrent unipolar disorder endorse experiencing manic/hypomanic symptoms over their lifetimes and compared their reports with those of patients with bipolar I disorder., Method: The study group included 117 patients with remitted recurrent unipolar depression and 106 with bipolar I. Subjects had their clinical diagnosis confirmed by the Mini International Neuropsychiatric Interview and were administered the Structured Clinical Interview for the Mood Spectrum, which assesses lifetime symptoms, traits, and lifestyles that characterize threshold and subthreshold mood episodes as well as "temperamental" features related to mood dysregulation., Results: The patients with recurrent unipolar depression endorsed experiencing a substantial number of manic/hypomanic symptoms over their lifetimes. In both patients with recurrent unipolar depression and patients with bipolar I disorder, the number of manic/hypomanic items endorsed was related to the number of depressive items endorsed. In the group with recurrent unipolar depression, the number of manic/hypomanic items was related to an increased likelihood of endorsing paranoid and delusional thoughts and suicidal ideation. In the bipolar I group, the number of lifetime manic/hypomanic items was related to suicidal ideation and just one indicator of psychosis., Conclusions: The presence of a significant number of manic/hypomanic items in patients with recurrent unipolar depression seems to challenge the traditional unipolar-bipolar dichotomy and bridge the gap between these two categories of mood disorders. The authors argue that their mood spectrum approach is useful in making a more accurate diagnostic evaluation in patients with mood disorders.

This article discusses the promise and problems associated with integrating research on child temperament and research on childhood psychopathology. Unfortunately, these 2 extensive and influential areas of psychological research with children have largely been conducted independently of each other. This article provides a summary of the disciplinary, conceptual, and methodological issues that have hampered an integration of these 2 important bodies of research. It also highlights the great promise that such an integration could have for advancing causal theories of childhood disorders and for eventually improving the treatment provided to children with serious emotional and behavioral disturbances.

Background: Certain aspects of the personality may be associated with the vulnerability to develop depression. A sib-pair method has been used to examine the familiality of the 7 scales of the Temperament and Character Inventory (TCI) and whether this could be related to the genetic vulnerability to develop depression., Methods: Probands with depression and their nearest-aged siblings from Wales were compared with healthy control probands and their nearest-aged siblings on the TCI and measures of depressed mood., Results: All 7 scales of the TCI were familial, and scores on 6 of the scales were similar to US population scores. However, the Welsh subjects' scores on the self-transcendence scale were markedly lower than the US mean, suggesting strong cultural or national influences on this measure. Harm avoidance scores were substantially influenced by current and past depression, but this scale also showed stable traitlike characteristics that are likely related to the genetic vulnerability to depression. Novelty seeking and self-directedness were also partly state-dependent and were negatively correlated with low mood; high scorers may be resilient to the development of depression. High reward dependence may also protect against the development of depression and is unrelated to mood state. The cooperativeness, persistence, and self-transcendence scales appear to have a limited relationship with the development of depression., Conclusions: Harm avoidance, reward dependence, novelty seeking, and self-directedness have traitlike characteristics that are related to the familiality of depression. Cooperativeness, self-transcendence, and persistence are also familial, but this appears to be unrelated to depression.

The authors investigated the link between children's temperament and the development of asthma and allergies. Prospective longitudinal data on children at the ages of 3-5 months, 3-5 years, and 7-9 years were collected. At age 7-9 years, analyses were performed on data for 3 groups of children (n = 42): those with asthma (no allergies), those with allergies (no asthma), and those with neither asthma nor allergies (the control group). Data for children who developed asthma or allergies prior to age 7-9 years were not analyzed. Differences were found in the premorbid period between the control group and the children who later developed asthma or allergies as well as between the asthma and allergy groups. After onset of illness, no temperamental differences were observed between the 3 groups. The study shows the importance of longitudinal design for asthma research.

Maternal reports of child temperament were used to develop temperament profiles of school-age children. The subjects were 883 children who were between 4 and 12 years of age. The children's families varied substantially in their socioeconomic status and race/ethnicity. To develop the profiles, the dimensions derived from the School-Age Temperament Inventory were subjected to a second order principal factor analysis with varimax rotation. Pearson chi-squares were used to determine whether sociodemographic variables were proportionally represented among the profiles. Forty-two percent of the children were classified into four temperament profiles. High maintenance and cautious/slow to warm up were deemed as challenging temperaments. Industrious and social/eager to try were mirror images of those profiles and were labeled easy. Some children were both types of challenging or easy profiles. The generalizability of the profiles in relation to the sociodemographic variables of gender, age, race/ethnicity, and socioeconomic status was also examined. Challenging temperament profiles were disproportionately represented by boys, Hispanic children, and those from lower socioeconomic families. Girls were over represented in the group that included both types of easy temperaments. Social/eager to try children were more often from higher rather than lower socioeconomic status families. Clinical applications and research implications for the profiles are discussed. The profiles can be used as exemplars that parents can use to recognize their child's temperament. Further research is needed to explore whether different developmental outcomes are associated with the profiles., (Copyright 2002, Elsevier Science (USA).)

The discovery of pharmacologic interventions that mute the intensity of anxiety and guilt in some individuals has been a benevolent gift to those who suffer from these disabling states. Although some commentators have wondered about the social consequences of large numbers of asymptomatic persons taking these drugs, few have questioned the advantages for the smaller group of anguished patients. It is likely, however, that, during the next century, scientists will discover a drug that eliminates the feeling components of guilt and remorse while leaving intact the semantic knowledge that certain acts are ethically improper. An individual who took this drug regularly would continue to know that deceiving a friend, lying to a client, and stealing from an employer are morally wrong but would be protected from the uncomfortable feeling of guilt or remorse that accompanies a violation of a personal moral standard. It is reasonable to wonder, therefore, whether our society would be changed in a major way if many citizens were protected from guilt and remorse. Most Western philosophers, especially Kant, made reason the bedrock of conscience. People acted properly, Kant believed, because they knew that the behavior was morally right. All individuals wish to regard the self as virtuous and try to avoid the uncertainty that follows detection of the inconsistency that is created when they behave in ways that are not in accord with their view of the self's desirable attributes. Kant believed that, although the moral emotions restrain asocial acts, they were not necessary for the conduct of a moral life. On the other hand, some philosophers, such as Peirce and Dewey, argued that anticipation of anxiety, shame, and guilt motivate a continued loyalty to one's ethical standards. A person who was certain that he or she was protected from these uncomfortable emotions would find it easier to ignore the moral imperatives acquired during childhood and adolescence. It is not obvious that a drug that blocks remorse also will eliminate the mutual social obligations that make a society habitable; nonetheless, a posture of vigilance that is appropriate for--unlike gorillas--humans can hold representations of envy, anger, and dislike toward people they have never met for a very long time. While we wait for future inquiry to resolve this issue, it is useful to acknowledge that a satisfying analysis of this problem will require a deeper appreciation of the differences between the representations of the biological events that are the foundation of an emotion and the representations that define the semantic networks for the concepts good and bad.

Objective: "Behavioral inhibition to the unfamiliar" has been proposed as a precursor to anxiety. A recent study proposed that it may also be a precursor to alcoholism. The authors sought to replicate the latter finding through a secondary analysis of data from a large study of young children (age 2-6 years)-offspring of parents with panic and depressive disorders-who had been assessed for behavioral inhibition through laboratory-based observations., Method: The offspring were stratified on the basis of presence or absence of parental lifetime history of DSM-III-R alcohol dependence (N=115 versus N=166, respectively) or drug dependence (N=78 versus N=203). The rates of behavioral inhibition were then compared between groups., Results: Despite adequate power to detect associations, neither parental alcohol dependence nor drug dependence was associated with a higher risk for behavioral inhibition in the offspring., Conclusions: These results are not consistent with the hypothesis linking behavioral inhibition to addictions.

Objective: The authors sought to examine psychopathological correlates of behavioral inhibition in young offspring of parents with panic disorder and/or major depression., Method: Behavioral inhibition, determined by using standard laboratory observations, was assessed in four groups of children (age 2-6 years): 129 children of parents with both panic disorder and major depression, 22 children of parents with panic disorder alone, 49 children of parents with major depression alone, and 84 comparison children of parents with neither panic disorder nor major depression. Psychopathology in children > or =5 years was compared between children with behavioral inhibition (N=64) and without (N=152)., Results: Social anxiety disorder (social phobia or avoidant disorder) was significantly more likely to be found in the children with behavioral inhibition (17%) than in those without (5%). Noninhibited children were significantly more likely than inhibited children to have disruptive behavior disorders (20% versus 6%, respectively) and had higher scores on the attention problems scale of the Child Behavior Checklist (mean=52.1 versus 50.8)., Conclusions: This study adds to the growing literature suggesting an association between behavioral inhibition and social anxiety disorder and an inverse relationship between inhibition and disruptive behavior disorders.

The present investigation focused on symptomatological subtypes of mania and their relationships with affective temperaments and other clinical features of bipolar disorder. In 153 inpatients with mania diagnosed according to DSM-III-R, symptomatological subtypes have been investigated by means of principal component factor analysis of 18 selected items of the Comprehensive Psychopathological Rating Scale (CPRS). We compared other clinical features, depressive and hyperthymic temperamental attributes, and first degree-family history for mood disorders among the various manic subtypes on the basis of the highest z-scores obtained on each CPRS factor (dominant CPRS factor groups). Five factors--Depressive, Irritable-Agitated, Euphoric-Grandiose, Accelerated-Sleepless, Paranoid-Anxious--emerged, accounting for 59.8% of the total variance. When the factor-based groups were compared, significant differences emerged in terms of the duration of the current episodes, rates of chronicity and incongruent psychotic features--being highest in the 'Depressive' and 'Paranoid-Anxious' dominant groups. The patients with highest z-scores for the 'Euphoric-Grandiose', 'Paranoid-Anxious' and 'Accelerated-Sleepless' factors were those most likely to belong to the hyperthymic temperament, while the 'Depressive' dominant group had the highest rate of depressive temperament. Finally, it is noteworthy that the 'Irritable-Agitated' group was high for both temperaments. The foregoing multidimensional structure of mania--revealing five factors--is generally concordant with the emerging literature. Consistently with our original hypothesis, a hyperthymic temperament seems to underlie the most extreme manic excitement with euphoric-accelerated-paranoid phenomenology. By contrast, the depressive temperament seemed to mute the expression of mania into a depressive-manic phenomenology.

Objective: This study examined the clinical and familial relationships between comorbid alcoholism and attempted suicide in affectively ill relatives of probands with bipolar I disorder., Method: In 71 families ascertained for a genetic linkage study, 337 subjects with major affective disorder were assessed by using the Schedule for Affective Disorders and Schizophrenia-Lifetime Version., Results: Subjects with bipolar disorder and alcoholism had a 38.4% lifetime rate of attempted suicide, whereas those without alcoholism had a 21.7% rate. Attempted suicide among subjects with bipolar disorder and alcoholism clustered in a subset of seven families. Families with alcoholic and suicidal probands had a 40.7% rate of attempted suicide in first-degree relatives with bipolar disorder, whereas other families had a 19.0% rate., Conclusions: Comorbid alcoholism was associated with a higher rate of attempted suicide among family members with bipolar disorder. Attempted suicide and alcoholism clustered in a subset of families. These relationships may have a genetic origin and may be mediated by intoxication, mixed states, and/or temperamental instability.

Objective: Examine the relationship between temperament variables and perceptions of nonshared environment as they relate to bulimia nervosa., Method: Fifty-seven adult women completed the Tridimensional Personality Questionnaire and the Sibling Inventory of Differential Experience. These measures provided assessments of frequently studied temperament traits as well as nonshared environmental factors believed to be associated with psychopathology and temperament., Results: Bulimic subjects showed higher levels of harm avoidance than did control subjects. Also, bulimic subjects perceived their fathers as less affectionate and more controlling than control subjects. Among bulimics, high levels of harm avoidance were associated with high levels of maternal affection and low levels of maternal control. Similarly, among bulimics, high levels of novelty seeking were more likely to be associated with decreased paternal control than was true for control subjects., Discussion: These findings highlight the possible relationship between particular temperamental variables and associated family responses in bulimia nervosa., (Copyright 2000 by John Wiley & Sons, Inc.)

Objective: Although previous studies have shown that dysthymia, or chronic depression, commonly responds to antidepressant medications (with improvements in depressive symptoms and psychosocial functioning), there have been no systematic studies of the impact of antidepressant treatment on personality variables in patients with this disorder., Method: In a multicenter study, 410 patients with early-onset primary dysthymia were treated in a randomized prospective fashion with sertraline, imipramine, or placebo. The data were analyzed in terms of the subjects' scores on the Tridimensional Personality Questionnaire, a 100-item self-report instrument that measures four temperamental dimensions: harm avoidance, reward dependence, novelty seeking, and persistence., Results: At baseline, the harm avoidance scores of the dysthymic subjects were approximately 1.5 standard deviations higher than those of a previously reported community sample. After treatment, there was a significant decrease in harm avoidance scores, with no significant between-group differences. Remission of dysthymia was associated with significantly greater improvement in harm avoidance, with the greatest numerical change found in the patients treated with sertraline. Subjects' Tridimensional Personality Questionnaire scores were correlated at a 0.50 level with the Social Adjustment Scale both pre- and posttreatment, suggesting that a high degree of harm avoidance may be associated with poor social functioning., Conclusions: Before treatment, chronically depressed patients demonstrate an abnormality in temperament, as measured by elevated degrees of harm avoidance. Remission of dysthymia is associated with improvement in this aspect of temperament.

Examines the tempers and uses of anger by various U.S. presidents, including Andrew Jackson, Theodore Roosevelt, Harry Truman, Richard Nixon, and Lyndon Johnson.

This study examined the convergent validity of the Temperament and Character Inventory (TCI), a measure of four biosocial temperaments and three character dimensions with the Coolidge Axis II Inventory (CATI), a measure of 14 personality disorders. A nonclinical sample of 163 college students was given both measures, and the data were analyzed with bivariate and multivariate statistics. Hypotheses generated from the findings of Svrakic, Whitehead, Przybeck, and Cloninger (1993, Archives of General Psychiatry, 50, 991-999) were confirmed for a majority of the relationships between the two measures. The preliminary results provide qualified support for the TCI and Cloninger's biosocial theory in the assessment of personality disorders.

Latencies to escape from a T-maze, and thereby reinstate visual contact with conspecifics, were measured in broiler chicks at 2 days of age. Chicks were assigned to high- (HP) or low- (LP) performance categories if their escape latencies fell below 25 s or above 75 s, respectively. These chicks were then housed socially in 10 same-category groups (5 HP, 5 LP), each comprising eight birds. At 15 days of age, one chick was taken from each of two randomly selected cages (1 HP, 1 LP) and immediately bled (undisturbed controls). At the same time, another chick was taken from each of these boxes and immersed up to its neck in warm water (partial water immersion, PWI) for 15 min before blood was collected. All chicks were sexed after bleeding. There were no differences between the plasma corticosterone (CS) levels of undisturbed (control) HP and LP chicks. Exposure to PWI significantly increased circulating CS levels, and this elevation was more pronounced in LP than in HP chicks. Male chicks also showed higher stress-induced adrenocortical responses than did females. The present findings suggest that the T-maze responses of young chicks might predict their later adrenocortical responses to a known stressor. This relationship is discussed in terms of individual differences in fearfulness, ability to cope with challenge, and/or stress susceptibility.

The purpose of the present study was to identify clinically relevant subtypes of aggressive children based on measures of children's self-systems and significant others' perceptions of relationship quality. In a sample of aggressive second- and third-graders, a cluster analysis of these children's perceptions of support and significant others' (mother, teacher, and peers) perceptions of relationship quality revealed one subgroup in which self- and other-ratings were both below the group mean (concordant-negative), one in which both were above the sample mean (concordant-positive), and one in which they were discrepant (high child-report and low other-report). All three clusters were rated as more aggressive than controls. However, children in the discrepant group were rated as considerably more aggressive and delinquent than those in the two concordant clusters, who did not differ from each other on measures of internalizing and externalizing behaviors. Results are discussed from an attachment perspective and in terms of the clinical significance of this self-other discrepancy.

Examined the construct validity of the Childhood Anxiety Sensitivity Index (CASI) in young children through the use of a behavioral challenge task. Elementary-school children completed the CASI as well as self-report measures of state and trait anxiety and subjective fear prior to and immediately following a stair-stepping task designed to increase physiological arousal. Results indicate that the CASI was a significant predictor of the degree of state anxiety and subjective fear reported in response to the challenge task, even after controlling for pretask levels of state anxiety and fear, respectively. Additionally, the CASI predicted changes in fear experienced in response to the challenge task. The findings lend support to the validity of the CASI in preadolescent children and suggest that the CASI possesses unique clinical utility relative to measures of trait anxiety. However, results of this study must be interpreted cautiously, because a large portion of the variance in response to arousal was left unaccounted for by the CASI and the overall model.

A population-based sample of Norwegian children aged 18 months (N = 921), 30 months (N = 784), and 50 months (N = 737) was examined with the EAS Temperament Survey (Buss & Plomin, 1984). The factor structure, psychometric properties, and stability estimates of the instrument were assessed. A cross-validation of the temperament factors of Emotionality, Activity, and Shyness show that the covariance structure conforms with the three scales described by Rowe and Plomin (1977) and Boer and Westenberg (1994). When items from the experimental scale of Sociability were included in the analysis, a four-factor solution confirmed the separate usability of this scale as well. The factor structure does not seem to vary substantially with the age of the children. The scores on the four temperament scales show high stability from one time of measurement to the next. Although no strong gender differences were found, there were significant age trends. Emotionality and Shyness increased from 18 to 50 months, while Activity and Sociability decreased. The study confirmed the structure and stability of the EAS over 3 years among young children, providing support for its use with children as young as 18 months.

A group of 164 children from different infant temperament categories were seen at 7 years of age for a laboratory battery that included behavioral and physiological measurements. The major results indicated that children who had been classified as high reactive infants at 4 months of age, compared with infants classified as low reactive, (a) were more vulnerable to the development of anxious symptoms at age 7 years, (b) were more subdued in their interactions with a female examiner, (c) made fewer errors on a task requiring inhibition of a reflex, and (d) were more reflective. Further, the high reactives who developed anxious symptoms differed from the high reactives without anxious symptoms with respect to fearful behavior in the second year and, at age 7 years, higher diastolic blood pressure, a narrower facial skeleton, and greater magnitude of cooling of the temperature of the fingertips to cognitive challenge. Finally, variation in magnitude of interference to fearful or aggressive pictures on a modified Stroop procedure failed to differentiate anxious from nonanxious or high from low reactive children.

Investigated stability and change in intrusive and withdrawn interaction behaviours of 23 mothers in Study 1 and 31 mothers in Study 2. Comparisons between mother-infant and mother-boyfriend interactions revealed that mothers who had been withdrawn with their infants were quiet, bored-looking, physically distant, and underinvolved with their boyfriends. Mothers who had been intrusive with their infants were verbally sharp and controlling with their boyfriends. These findings suggested stability across social contexts. Comparing maternal responding to instructions to think about themselves (self-focus) or their infants (infant-focus) revealed that infant-focusing attenuated intrusive behavior among intrusive mothers and self-focusing attenuated negative affect among withdrawn mothers. These findings suggested that cognitive focusing ameliorates nonoptimal maternal behaviours and has differential effects on intrusive and withdrawn mothers.

We tested the hypotheses that the hostility and anger scales of the Buss and Perry (1992) [Buss, A. H. & Perry, M. (1992). The Aggression Questionnaire. Journal of Personality and Social Psychology, 63, 452-459.] Aggression Questionnaire would predict anger in college students in response to mistreatment. We found low and high hostility groups did not differ in anger at baseline or after completing a task without provocation, but the high hostility group reported greater anger than the low group after the onset of provocation, which required all students to redo completed tasks because some students (confederates) were observed cheating. Hostility also influenced anxiety and depression, but only anger was greater as a result of the provocation in the high than in the low hostility group. The anger scale did not predict anger in response to provocation, but anger was higher in the high than the low anger group before the provocation. These findings support the construct validity of the Aggression Questionnaire hostility scale as a measure of suspicion, resentment and sensitivity to mistreatment.

In one of a set of studies exploring the need for time alone throughout development, infant temperamental characteristics, their relation to infant needs for time alone, and maternal perceptions of these needs are examined via videotapings of the infants' signals of disengagement and engagement. Descriptive data based on three mother-infant dyads suggest that infants clearly signal their needs for rest and disengagement in the first eight weeks, and develop unique patterns of "alonetime" behavior that may be related in part to temperamental differences.