High Harm Avoidance Research Articles

Temperament personality profiles in suicidal behaviour: An investigation of associated demographic, clinical and genetic factors

BackgroundPersonality traits have been suggested as possible risk factors for suicidal behaviours. Cloninger's model of personality (TCI), given its neurobiological background, might provide an ideal tool for the identification of dimensions associated with suicide attempt. MethodsA number of 1333 suicide attempters and 589 non-suicide attempters suffering from different DSM-IV Axis I disorders were assessed using either the temperament and character inventory (TCI) or the tridimensional personality questionnaire (TPQ), as well as other self-report questionnaires evaluating dimensions associated with suicidal behaviour, such as impulsivity and anger traits. The severity of suicide attempts and the methods used were also assessed. Subjects were genotyped for polymorphisms within the key genes involved in monoaminergic pathways and the HPA axis. ResultsCompared with non-suicide attempters, suicide attempters scored higher for harm avoidance (HA) and novelty seeking (NS), and lower for self-directedness (SD). The difference was independent of Axis I disorders. Higher HA and NS scores were associated with a greater severity of suicidal behaviour. A multivariate model showed that HA was the single temperamental dimension independently related to suicide attempt history, beside impulsivity and anger-related traits. The genetic factors investigated did not play a significant role in modulating these temperamental dimensions. LimitationsThe TCI was available for only half of the sample. ConclusionsEarly detection of subjects displaying high HA and low SD, associated with high impulsivity and poor anger control, may help to prevent suicidal behaviours. Physicians should therefore be aware of these risk factors so that they can offer the best primary care intervention.

Personality dimensions and Working Alliance in subjects with Borderline Personality Disorder

BackgroundAs yet, the relation between personality traits and working alliance (WA) has not been investigated in subjects affected by borderline personality disorder (BPD). MethodA sample of forty-nine BPD subjects who completed a module of Sequential Brief Adlerian Psychodynamic Psychotherapy (SB-APP) of 40 sessions has been recruited. Before the onset of psychotherapy an assessment was made with Clinical Global Impression (CGI), Global Assessment of Functioning (GAF), Symptom Checklist Revised 90 (SCL-R 90), and with Temperament and Character Inventory (TCI). At the end of their psychotherapy, patients were requested to rate the level of WA by means of the Working Alliance Inventory (WAI-S). ResultsMultiple linear regression analysis has identified three variables as independent predictors of WAI-S total score: subjects with lower Harm Avoidance (HA), older patients, and subjects with a higher psychopathology level had a better WAIS total score. DiscussionThese preliminary results showed that the pattern of alliance with the therapist in subjects with BPD could be related not only to weakness of character, but also to a temperamental trait typical of inhibited and avoidant subjects. ConclusionThese results suggest that an assessment of temperament in subjects affected by BPD at intake could be useful to detect the subjects who have more difficulties in building a good WA and in order to improve the technical interventions and settings for psychotherapy of BPD subjects with higher HA.

Increased Prevalence of Anxiety-Associated Personality Traits in Patients with Cushing's Disease: A Cross-Sectional Study

Background/Aims: Chronic hypercortisolism in Cushing's disease (CD) has been suggested to contribute to an altered personality profile in these patients. We aimed to test this hypothesis and attempted to determine the effects of disease- and treatment-related factors that might moderate an altered personality in CD. Methods: We assessed 50 patients with CD (74% biochemically controlled) and compared them to 60 patients with non-functioning pituitary adenomas (NFPA) and 100 age- and gender-matched mentally healthy controls. Personality was measured by two standardized personality questionnaires, TPQ (Cloninger Personality Questionnaire) and EPQ-RK (Eysenck Personality Questionnaire-RK). Results: Compared to mentally healthy controls, CD patients reported significantly less novelty-seeking behaviour, including less exploratory excitability and less extravagance. On harm avoidant subscales, they presented with more anticipatory worries and pessimism, higher fear of uncertainty, shyness with strangers, fatigability and asthenia. Moreover, CD patients appeared to be less extraverted, more neurotic and socially desirable. CD patients differed from NFPA patients in terms of higher neuroticism scores, and NFPA patients did not show altered novelty-seeking behaviour or extraversion. In the subgroup analysis, CD patients with persistent hypercortisolism displayed significantly higher fear of uncertainty, fatigability and asthenia, indicating high harm avoidance in total, than those in biochemical remission. Conclusion: Patients with CD showed a distinct pattern of personality traits associated with high anxiety in combination with traits of low externalizing behaviour. Such personality changes should be taken into account in the diagnosis and treatment of CD patients, as they might interfere with the patient-physician communication and/or challenge the patients' social and psychological functioning.

Temperament and character dimensions and their relationship to major depression and panic disorder

Since the first publication of Cloninger's psychobiological model of personality, the relationship between temperament and character dimensions and psychiatric disorders has been widely studied. The exact nature of this interaction, however, is still unclear. Different models have been proposed (state-dependency, vulnerability, continuous spectrum etc). To analyze the relationship between temperament and character dimensions with depression and panic disorder. Systematic review on interventional studies published up until December 2011 on MEDLINE and ISI databases. Also, a brief review on genetic studies is hereby undertaken, aiming to discuss the gene-environment interaction in relation to this topic. Thirteen studies were included: 10 related to depression and 3 to panic disorder (or unspecific anxiety symptoms). All of them showed association between high harm avoidance (HA) and low self-directedness (SD) with depression and anxiety symptoms. Longitudinal studies demonstrated that these traits may not be just state-dependent. HA and SD dimensions are associated with both the occurrence of depressive and anxiety symptoms. There is also some evidence to suggest that high HA and low SD indicates susceptibility to depression. Longitudinal studies are not sufficient to affirm the same about panic disorder up to the present moment.

Temperament and Character Modify Risk of Drug Addiction and Influence Choice of Drugs

Drug addiction and alcoholism involve a complex etiopathogenesis with a variable degree of risk contributions from the host (person), environment, and addictive substances. In this work, temperament and character features of individuals addicted to opiates or alcohol are compared with normal controls to study personality factors in the overall risk for drug addiction. The study was done in a permissive environment, with easy access to alcohol and heroin, which facilitated analyses of personality factors in drug choice. Participants included 412 consecutive patients (312 opiate addicts, 100 alcohol addicts) treated at the Specialized Hospital for Chemical Dependency in Belgrade, Serbia, and a community sample of 346 controls. Opiate addicts manifested antisocial temperament configuration (high Novelty Seeking, low Reward Dependence) coupled with high Self-transcendence (ie, susceptibility to fantasy and imagination). Alcohol addicts manifested sensitive temperament configuration (high Novelty Seeking coexisting with high Harm Avoidance). Immature personality was observed far more frequently in opiate addicts than in alcoholics or normals. Novelty Seeking appears to be a general risk factor for drug addiction. High Harm Avoidance appears to channel individuals with high Novelty Seeking towards alcoholism. Immature character traits and probable Personality Disorder increase the risk of illegal drugs. Based on equivalent research in nonpermissive environments, at least a portion of our opiate addicts could have developed alcoholism instead in environments with more limited access to opiates. Personality factors provide useful guidelines for preventive work with young individuals with personality risk factors for drug addiction.

Association between morningness-eveningness and temperament and character in community-dwelling Korean adults

Previous studies have reported an association between biogenetic temperament/character and circadian preference in Spanish or French college students. Our aim is to investigate the association between temperament/character and circadian preference in psychiatrically healthy, community-dwelling Korean adults of a wide age range. Subjects free of Axis I disorders (n = 342) completed the Morningness-Eveningness Questionnaire and the Temperament and Character Inventory. High Novelty Seeking and low Self-Directedness was associated with eveningness. In contrast to prior studies on college students, eveningness was associated with high (not low) Harm Avoidance. Eveningness-Novelty Seeking association and Eveningness-Harm Avoidance association were prominent in females. Eveningness-Novelty Seeking was prominent in the older group (age ≥40), while Eveningness-Harm Avoidance was prominent in the younger group (age ≤40). Despite the limitation of the small sample size, the present study suggests that eveningness is associated with high Novelty Seeking/Harm Avoidance and low Self-Directedness in community-dwelling adults, and that this association may be related to age, gender, and other sociocultural factors.

Dimensiones de la personalidad y alianza terapéutica en individuos con trastorno límite de la personalidad

As yet, the relation between personality traits and working alliance has not been investigated in subjects affected by Borderline Personality Disorder (BPD).A sample of forty-nine BPD subjects who completed a module of Sequential Brief Adlerian Psychodynamic Psychotherapy (SB-APP) of 40 sessions has been recruited. Before the onset of psychotherapy an assessment was made with Clinical Global Impression (CGI), Global Assessment of Functioning (GAF), Symptom Checklist Revised 90 (SCL-R 90), and with Temperament and Character Inventory (TCI). At the end of their psychotherapy, patients were requested to rate the level of working alliance by means of the Working Alliance Inventory (WAI-S).Multiple linear regression analysis has identified three variables as independent predictors of WAI-S total score: subjects with lower Harm Avoidance, older patients, and subjects with a higher psychopathology level had a better WAIS total score.These preliminary results showed that the pattern of alliance with the therapist in subjects with BPD could be related not only to weakness of character, but also to a temperamental trait typical of inhibited and avoidant subjects.These results suggest that an assessment of temperament in subjects affected by BPD at intake could be useful to detect the subjects who have more difficulties in building a good working alliance and in order to improve the technical interventions and settings for psychotherapy of BPD subjects with higher Harm Avoidance.

Temperament and character traits in patients with bipolar disorder and associations with attempted suicide

ObjectiveThis study was intended to investigate temperament and character traits in bipolar disorder patients with or without a history of attempted suicide. MethodsOne hundred nineteen patients diagnosed with euthymic bipolar disorder based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, and with no accompanying Axis I and II comorbidity, and 103 healthy controls were included. Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I and II disorders were used to exclude Axis I and II comorbidity. Temperament and character traits of bipolar patients with a history attempted suicide (25.2%, n = 30) or without (74.8%, n = 89) and of the healthy volunteers were determined using the Temperament and Character Inventory. The association between current suicide ideation and temperament and character traits was also examined. ResultsBipolar patients with or without a history of attempted suicide had higher harm avoidance (HA) scores compared with the healthy controls. Persistence scores of bipolar patients with no history of attempted suicide were lower than those of the healthy controls. Self-directedness (SD) scores of the bipolar patients with a history of attempted suicide were lower than those of patients with no such history. Self-transcendence scores of bipolar patients with no history of attempted suicide were lower than those of both the healthy controls and of those patients with a history of attempted suicide. A positive correlation was determined between current suicidal ideation scale scores and HA, and a negative correlation between SD and cooperativeness was determined. ConclusionsHigh harm avoidance may be a temperament trait specific to bipolar disorder patients. However, it may not be correlated with attempted suicide in such patients. These may have low persistence, high SD and low self-transcendence temperament and character traits that protect against attempted suicide. Harm avoidance, SD, and cooperativeness may be correlated with current suicidal ideation.

Personality profile in essential tremor: A case–control study

BackgroundNeuropsychiatric findings described in essential tremor (ET) include depression and anxiety. There may be personality features as well; in 2004, we demonstrated higher harm avoidance (HA) scores in ET patients than controls. We now (1) determined whether this finding could be replicated in a new sample of cases and controls, and (2) analyzed HA sub-scores (HA1−HA4) to further understand case–control differences. Design/Methods60 ET cases and 35 controls were evaluated using the Tridimensional Personality Questionnaire (TPQ), which assesses three domains of personality: HA, novelty seeking (NS), and reward dependence (RD). ResultsTotal HA and total NS scores were marginally higher in cases than controls (14.8 ± 7.6 vs. 12.4 ± 5.3, p = 0.09) and (13.8 ± 5.4 vs. 11.8 ± 4.9, p = 0.09), respectively. When adjusted for age and gender, cases and controls differed with respect to total HA score (p = 0.03) but not total NS score (p = 0.10). Further analysis of HA sub-scores demonstrated that HA1 (anticipatory worry and pessimism) and HA4 (fatigability and asthenia) were most robustly elevated in cases vs. controls (p = 0.04 and p = 0.01, respectively). ConclusionsThis study suggests that ET cases have a personality profile characterized by a greater HA, with certain domains of HA most affected. It is unclear whether this personality profile is pre-morbid or is a co-morbid feature of the illness, nor it is known whether the greater tendency towards HA in ET lessens receptivity to deep brain stimulation surgery and other therapies.

Dependencia de Opiáceos tipo II o antisocial: utilidad del Modelo Psicobiológico de Cloninger en adicciones

The aim was to analyze the relationship between Cloninger's dimensions and Personality Disorders (PD) (with DSM-IV criteria) in opiate dependents. The study was Cross-sectional. The sampling of 196 patients with opiate dependence was consecutive. All were receiving treatment in an inpatient detoxification unit. Cloninger's Temperament and Character Inventory (TCI), International Personality Disorders Examination (IPDE) and a Substance Use Questionnaire were used. Character's dimensions as Self-directness and Cooperation were related with PD when scored low. Opposite to Cloninger descriptions, high scores of Self-transcendence were related with presence of PD. Related to temperamental dimensions, cluster A was related with low scores of Reward Dependence (RD) and cluster C with high scores of Harm Avoidance (HA). Otherwise, in cluster B, while Borderline PD had high scores of Novelty Seeking (as high HA), the Antisocial PD only were related to low scores of RD. RD dimension seems useful to differ from presence or absence of Antisocial PD, also when alcohol consumption is considered. Cloninger's Model of Personality is useful in drug dependents for the definition of the different PD, as well as for probable PD's aggregation. This model also helps to create subtypes in opiate dependents as the antisocial or type II.

Methadone-Mediated Autonomic Functioning of Male Patients with Heroin Dependence: The Influence of Borderline Personality Pattern

BackgroundWe hypothesize that the population with borderline personality shows different autonomic response to methadone compared to individuals with other personalities. This study applies heart rate variability (HRV) measurements and the Tridimensional Personality Questionnaire (TPQ) to examine this hypothesis.Methodology/Principal FindingsForty-four male patients with heroin dependence were recruited from a methadone maintenance treatment program. Eight personality patterns were classified according to the TPQ norm used in Taiwan. The borderline pattern (BP, composed of high novelty seeking, high harm avoidance and low reward dependence) and the other personality patterns (OP) were separated into two groups. We compared the HRV profiles between the BP and OP groups. Correlation and regression analysis were performed to clarify relationship between HRV differences and the borderline index (BI, a new concept defined by us, which is calculated as novelty seeking + harm avoidance – reward dependence). The HRV targets investigated included low frequency (LF) power, high frequency (HF) power, total power (TP), normalized LF (LF%), and LF/HF. No baseline HRV parameters showed any inter-group difference. The BP group had a significantly lower ΔHF and a higher ΔLF/HF than the OP group. The personality dimension, reward dependence, showed a negative correlation with ΔLF/HF and ΔLF%. BI was negatively correlated with ΔHF and positively correlated with ΔLF/HF and ΔLF%.Conclusions/SignificanceBorderline personality individuals show increased sympathetic activity and decreased parasympathetic activity compared to other personalities after taking methadone. The results support the hypothesis that there is an interaction between borderline personality and autonomic modulation.

Brain white matter organisation in adolescence is related to childhood cerebral responses to facial expressions and harm avoidance

While white matter structural integrity is likely to influence the responses to social-emotional stimuli and emotional regulation during development, no longitudinal data are available on such relationships. We investigated the relationships between white matter Fractional Anisotropy (FA) derived by DTI voxelwise Tract Based Spatial Statistics (TBSS) and tractography measured at ages 14-15, and cerebral event-related N400 amplitudes in response to happy, neutral and angry facial expressions and Cloninger's Harm Avoidance (HA) measured at ages 7-9. Whole-skeleton TBSS analyses revealed reduced FA associated to smaller N400 amplitudes in response to anger, and to higher HA. Region-of-Interest TBSS analyses showed high correlations (ranging -0.69-0.82, p<0.01-0.001) between FA and N400 amplitudes across the Inferior Longitudinal, the Inferior Frontoccipital, and the left Uncinate Fasciculus, and between FA and Harm Avoidance in right Uncinate Fasciculus (-0.71, p<0.01). Tractography showed that these relationships were mainly present in the left Inferior Longitudinal and the right Inferior Fronto-Occipital Fasciculus for N400 amplitudes, and in the right Uncinate Fasciculus for HA. Ventral limbic pathways' white matter organisation affects the neural responses to expressions - such as anger - that are perceptually more challenging and/or communicate social rejection, and compounds the neural pathways that predispose to avoidant behaviour and shyness with strangers.

Temperament trait Harm Avoidance associates with μ-opioid receptor availability in frontal cortex: A PET study using [11C]carfentanil

Harm Avoidance is a temperament trait that associates with sensitivity to aversive and non-rewarding stimuli, higher anticipated threat and negative emotions during stress as well as a higher risk for affective disorders. The neurobiological correlates of interindividual differences in Harm Avoidance are largely unknown. We hypothesized that variability in Harm Avoidance trait would be explained by differences in the activity of μ-opioid system as the opioid system is known to regulate affective states and stress sensitivity. Brain μ-opioid receptor availability was measured in 22 healthy subjects using positron emission tomography and [(11)C]carfentanil, a selective μ-opioid receptor agonist. The subjects were selected from a large Finish population-based cohort (N=2075) on the basis of their pre-existing Temperament and Character Scores. Subjects scoring consistently in the upper (10) and lower (12) quartiles for the Harm Avoidance trait were studied. High Harm Avoidance score associated with high μ-opioid receptor availability (i.e. lower endogenous μ-opioid drive) in anterior cingulate cortex, ventromedial and dorsolateral prefrontal cortices and anterior insular cortex. These associations were driven by two subscales of Harm Avoidance; Shyness with Strangers and Fatigability and Asthenia. In conclusion, higher Harm Avoidance score in healthy subjects is associated with higher μ-opioid availability in regions involved in the regulation of anxiety as well as in the control of emotions, affective component of pain and interoceptive awareness. The results have relevance in the research of vulnerability factors for affective disorders.

Biogenetic temperament and character in insomnia and depression

ObjectiveWe compared the biogenetic temperaments and characters of primary insomnia patients, major depressive disorder (MDD) patients with insomnia, MDD patients without insomnia, and normal controls. MethodsA total of 417 participants were recruited from a community and a psychiatric clinic in South Korea. Subjects were divided into 4 groups based on the Structured Clinical Interview for DSM-IV axis I disorder (SCID-IV) and sleep questionnaire: 1) normal controls (n=314), 2) primary insomnia (n=33), 3) MDD without insomnia (n=30), and 4) MDD with insomnia (n=40). All participants were requested to complete the Temperament and Character Inventory. ResultsThere were significant between-group differences in harm avoidance (HA)(F=32.96, p<0.001), reward dependence (RD)(F=5.21, p<0.01), self-directedness (SD)(F=24.72, p<0.001) and cooperativeness (CO)(F=15.75, p<0.001), after controlling for age and gender. Subjects with primary insomnia showed higher HA and lower SD than normal control, but lower HA and higher SD than MDD patients with insomnia. CO was lower in MDD patients, but not in subjects with primary insomnia. Lower RD was found only in MDD patients with insomnia. ConclusionThe current study suggests that high HA and low SD were related to primary insomnia, although these patterns were more prominent in patients with MDD.

PCLO gene: Its role in vulnerability to major depressive disorder

A recent genome-wide association study on Major Depressive Disorder (MDD) identified a specific association with a non-synonymous polymorphism (rs2522833) of a gene encoding the presynaptic protein piccolo (PCLO). A high percentage of patients who develop MDD have particular temperamental traits, such as passivity, pessimism, indecisiveness, and low self-esteem, which are related to the subsequent development of depression. The aims of this study were to perform a replicate case-control study and to conduct the first association study between the rs2522833 polymorphism and depression-related personality traits using the Temperament and Character Inventory (TCI) in a healthy subject sample. A total of 522 MDD patients and 375 healthy volunteers were enrolled in the study. Two hundred and forty-six controls agreed to fill out the TCI. The results showed that rs2522833 CC homozygotes were more frequent among the depressed patients than in the controls (p<0.01). The C allele distribution showed a trend in the same direction (p=0.08). Among controls, we found that the C allele carriers were associated with personality traits increasing vulnerability to depression, including higher Harm Avoidance (HA) and lower in Novelty Seeking (NS). In particular, C allele carriers were more fearful (HA2) and fatigable (HA4), and less impulsive/more deliberate (NS2) and less extravagant/more frugal (NS3). The absence of possible epistatic interaction effect. These results provide further support for the involvement of the PCLO gene in MDD and show that this effect may be mediated by influencing personality traits that increase the risk of major depression.

Relationship between defense styles, alexithymia, and personality in alcohol-dependent inpatients

In the present study, the defense styles were assessed in alcohol-dependent patients to verify whether they used less adaptive defense mechanisms compared with healthy controls and to evaluate if immature defense styles (IDSs) are related with alexithymia, while controlling the effect of age, temperament, and character on this relationship in male alcohol-dependent inpatients. Participants were consecutively admitted 118 male alcohol-dependent inpatients and 60 healthy controls. Patients were investigated with the Defense Style Questionnaire, the Toronto Alexithymia Scale, and the Temperament and Character Inventory. The alcohol-dependent patients were using neurotic defense style, some IDSs (projection, acting out, splitting, and somatization) more, and the mature defense style humor less than the control group. Together with higher age, IDS discriminated alcohol dependents from the control group (higher age, acting out, and splitting and lower humor in the second regression model). Immature defense style was positively correlated with novelty seeking, harm avoidance, self-transcendence, difficulty in identifying feelings (DIF), difficulty in describing feelings, external oriented thinking, and total alexithymia score in the present study, whereas it was negatively correlated with self-directedness and cooperativeness. Mean scores of neurotic and IDS were higher in the alexithymic group than the nonalexithymic group, and alexithymia was correlated with some IDSs. Higher difficulty in describing feelings predicted mature defense style, higher harm avoidance and DIF predicted neurotic defense style, and lower cooperativeness and self-transcendence and higher DIF predicted IDS. These suggest that alcohol dependents are using maladaptive IDS more, which can be taken into account in the development of therapeutic programs for these patients. In addition, IDS seems to be related with alexithymia, particularly DIF factor, whereas low cooperativeness and high self-transcendence are significant covariants. Thus, these results could indicate the use of specific strategies in the clinical and psychotherapeutic management of patients with alexithymic feature and IDS.

Abstract 3781: Harm Avoidance: A Novel Risk Factor for Cerebral Infarction

BACKGROUND: Harm avoidance, a trait indicative of behavioral inhibition, is associated with disability and dementia in old age, but the basis of these associations is uncertain. OBJECTIVE: To test the hypothesis that higher level of harm avoidance is associated with increased risk of cerebral infarction. METHODS: Longitudinal clinical-pathologic cohort study. Subjects were from the Rush Memory and Aging Project. As part of this longitudinal study, 1,082 older persons without dementia completed a standard measure of harm avoidance: the 35-item Harm Avoidance Scale from Cloninger’s Temperament and Character Inventory. During a mean of 3.5 years of follow-up, 258 individuals died of whom 206 (80%) underwent brain autopsy, the results of which are currently available in 192. Main Outcome Measures: Number of chronic gross and microscopic cerebral infarctions (each expressed as 0,1, or &gt;1) identified on a uniform neuropathologic examination. RESULTS: Trait scores ranged from 0 to 32 and were approximately normally distributed (mean 11.6 ± 7.0 SD). On postmortem examination, chronic microscopic infarction was found in 45 (28 with 1, 17 with &gt;1) and chronic gross infarction was found in 66 (31 with 1, 35 with &gt; 1). In a Bivariate Dale Model adjusted for age, sex, and education, higher harm avoidance was associated with higher likelihood of both microscopic (estimate = -0.08, SE = 0.02, p = 0.002) and gross (estimate = -0.06, SE = 0.02, p = 0.011) cerebral infarction. A high level of the trait (score=17, 75th percentile) was associated with an approximate doubling of the likelihood of each type of infarction (2.4- fold increase for microscopic, 1.8-fold increase for gross) compared to a low level of the trait (score = 6, 25th percentile). These associations persisted in subsequent models that controlled for cognitive and motor function, cardiovascular risk factors and conditions, or neuroticism, and it was stronger for subcortical than cortical infarction. CONCLUSIONS: Higher level of the harm avoidance trait may be a risk factor for cerebral infarction, both gross and microscopic. The mechanism appears independent of known cardiovascular risk factors and warrants further study.

Temperamental Profiles of Dysregulated Children

It is crucial to characterize self-regulation in children. We compared the temperamental profiles of children with the Child Behavior Checklist (CBCL) Dysregulation Profile (CBCL-DP) to profiles associated with other CBCL-derived syndromes. 382 children (204 boys; aged 5-18) from a large family study were examined. Temperamental profiles were based on the Juvenile Temperament and Character Inventory. Children with the CBCL-DP had a temperamental profile characterized by high Novelty Seeking, high Harm Avoidance, low Reward Dependence and low Persistence. Linear mixed models and regression-based models demonstrated that the CBCL-DP was associated with a "disengaged" temperamental profile. This profile is similar to the profile seen in adult disorders of self-regulation, including cluster B personality disorders. These results support the hypothesis that the CBCL-DP measures poor self-regulation.

Predicting Depression with Psychopathology and Temperament Traits: The Northern Finland 1966 Birth Cohort

We studied the concurrent, predictive, and discriminate validity of psychopathology scales (e.g., schizotypal and depressive) and temperament traits for hospitalisations due to major depression. Temperament, perceptual aberration, physical and social anhedonia, Depression Subscale of Symptom Checklist (SCL-D), Hypomanic Personality Scale, Schizoidia Scale, and Bipolar II Scale were completed as part of the 31-year follow-up survey of the prospective Northern Finland 1966 Birth Cohort (n = 4941; 2214 males). Several of the scales were related to depression. Concurrent depression was especially related to higher perceptual aberration (effect size when compared to controls, d = 1.29), subsequent depression to high scores in SCL-D (d = 0.48). Physical anhedonia was lower in subjects with subsequent depression than those with other psychiatric disorders (d = −0.33, nonsignificant). Participants with concurrent (d = 0.70) and subsequent (d = 0.54) depression had high harm avoidance compared to controls, while differences compared to other psychiatric patients were small. Subjects with depression differed from healthy controls in most of the scales. Many of the scales were useful predictors for future hospital treatments, but were not diagnosis-specific. High harm avoidance is a potential indicator for subsequent depression.

Personality and Major Depression among Directly Exposed Survivors of the Oklahoma City Bombing.

Background. Few disaster studies have specifically examined personality and resilience in association with disaster exposure, posttraumatic stress disorder (PTSD), and major depression. Methods. 151 directly-exposed survivors of the Oklahoma City bombing randomly selected from a bombing survivor registry completed PTSD, major depression, and personality assessments using the Diagnostic Interview Schedule for DSM-IV and the Temperament and Character Inventory, respectively. Results. The most prevalent postdisaster psychiatric disorder was bombing-related PTSD (32%); major depression was second in prevalence (21%). Bombing-related PTSD was associated with the combination of low self-directedness and low cooperativeness and also with high self-transcendence and high harm avoidance in most configurations. Postdisaster major depression was significantly more prevalent among those with (56%) than without (5%) bombing-related PTSD (P < .001) and those with (72%) than without (14%) predisaster major depression (P < .001). Incident major depression was not associated with the combination of low self-directedness and low cooperativeness. Conclusions. Personality features can distinguish resilience to a specific life-threatening stressor from general indicators of well-being. Unlike bombing-related PTSD, major depression was not a robust marker of low resilience. Development and validation of measures of resilience should utilize well-defined diagnoses whenever possible, rather than relying on nonspecific measures of psychological distress.