Article

Validating affective temperaments in their subaffective and socially positive attributes: Psychometric, clinical and familial data from a French national study

International Mood Center, VA Psychiatry Service, VA Hospital, University of California at San Diego, 3350 La Jolla Village Dr. (116-A), San Diego, CA 92161, USA.
Journal of Affective Disorders (Impact Factor: 3.71). 03/2005; 85(1-2):29-36. DOI: 10.1016/j.jad.2003.12.009
Source: PubMed

ABSTRACT 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.
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.
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.
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.

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    • "In the TCI, both the temperament category of reward dependence (related to warm social affiliations, separation distress, sympathy, and social sensitivity ), and the character component cooperativeness (ability to accept of others, listen and cooperate), describe social and relational proclivities. Concerning the TEMPS-A, although its questions are devoid of specific relational language or context, Akiskal's list of the survival-related events that elicit and reflect affective proclivities (i.e., being enamored and jilted, dominance-submission hierarchies, tendency toward fealty, territoriality), are inherently relational (Akiskal et al., 2005a). Furthermore, from a neurobiological vantage, both of these scales ultimately reflect the function of underlying socioemotional brain systems, and components of each scale have been associated with central systems related to social reward (Bachner-Melman et al., 2005; Gerretsen et al., 2010; Lebreton et al., 2009), including the oxytocin system (Bell et al., 2006; Cloninger, 1994; Groppe et al., 2013; Kawamura et al., 2011; Tost et al., 2010a). "
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    ABSTRACT: Background As the result of extensive translational and cross-disciplinary research, attachment theory is now a construct with significant neuropsychiatric traction. The correlation of attachment with other influential conceptual models (i.e. temperament and personality) is therefore of interest. Consequently, we explored how two attachment dimensions (attachment anxiety and attachment avoidance) correlated with measures of temperament and personality in 357 psychiatric outpatients. Methods We performed a retrospective review of four questionnaires (the Experiences in Close Relationship scale (ECR-R), Temperament and Character inventory (TCI), Temperament Evaluation of the Memphis, Pisa, Paris and San Diego questionnaire (TEMPS-A), and Personality Self-Portrait Questionnaire (PSQ)). Frequency measures and correlations were examined, as was the predictive value of attachment security for a personality disorder (PD). Results Significant, robust correlations were found between attachment anxiety and (1) several negative affective temperaments (dysthymic and cyclothymic); (2) several indices of personality pathology (low self-directedness (TCI), DSM-IV paranoid, borderline, histrionic, avoidant and dependent personality traits). Attachment avoidance had fewer large correlations. In an exploratory model, the negative predictive value of attachment security for a PD was 86%. Limitations Subjects were a relatively homogeneous subset of ambulatory psychiatric outpatients. PD diagnoses were via self-report. Conclusions Clinically, these findings highlight the significant overlap between attachment, affective temperament, and personality and support the value of attachment as a screen for PDs. More broadly, given our growing understanding of the neurobiology of attachment (i.e. links with the oxytocin system), these results raise interesting questions about underlying biological systems and psychiatric treatment.
    Journal of Affective Disorders 12/2013; 151(3):932–941. DOI:10.1016/j.jad.2013.07.040 · 3.71 Impact Factor
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    • "Among the personality variables studied, neuroticism was independently associated with self-reported somatic symptoms in large community samples (Rosmalen et al., 2007; Neeleman et al., 2004). Akiskal and collaborators (Akiskal et al., 2005a, 2005b) operationalized the concept of affective temperaments for use in research based on theoretical and clinical observations from the seminal works of Kraepelin (1921) and Kretschmer (1936). Recently, Lara et al. (2012a) extended the concept of affective temperaments to include 12 predominant types, namely euthymic, depressive, anxious, apathetic, obsessive, cyclothymic, dysphoric, irritable, volatile , disinhibited, hyperthymic and euphoric. "
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