Henrik Anckarsäter, MD, PhD

• MD, PhD
• Professor (Full) at University of Gothenburg

This chapter explores the interplay between personality traits, particularly Self-Directedness and Cooperativeness, and psychosocial functioning in children with neurodevelopmental disorders, framed within the ESSENCE model (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations). By re-analyzing data from Garcia, Anckarsäte...

RATIONALE: Personality, the major single determinant of people’s overall health, comprises temperament (automatic emotional reactions), character (goals and values), and identity (sense of self and who we are). These dimensions are often approached separately and have their basis in memory and learning systems that are dissociable developmentally a...

Background: Treatment of mentally disordered offenders (MDOs) is challenging as their behavior and clinical conditions can be traced to a complex constellation of major mental disorders, substance use and antisocial lifestyle. Finding subgroups of these offenders, which could guide treatment and risk assessment, is desirable. There are few long-ter...

Previous studies have shown an association between IQ and adaptive global functioning, i.e. how well a person is functioning in different domains of life. However, it is unclear to what extent such an association applies in children with neurodevelopmental disorders (NDDs). The study group consisted of 550 population-screened children assessed with...

Background Conduct disorder (CD), a serious behavioral and emotional disorder in childhood and adolescence, characterized by disruptive behavior and breaking societal rules. Studies have explored the overlap of CD with neurodevelopmental problems (NDP). The somatic health of children with NDP has been investigated; however, the prevalence of these...

Human beings are definitely storytellers capable of travel back and forward in time. We not only construct stories about ourselves, but also share these with others (McAdams and McLean 2013). We construct and internalize an evolving and integrative story for life, that is, a narrative identity (Singer 2004). However, the life story is just one of t...

Autism spectrum disorder (ASD) is diagnosed more often in boys than girls. Here, we compared the degree of autism - and related disorders - symptomatology in boys and girls with a registered diagnosis of ASD. We used parent telephone interview A-TAC (Autism-Tics, ADHD and other Comorbidities) ratings of 30,392 twins aged 9 or 12 (including 308 boys...

Objective The immune system has been suggested to be associated with neuropsychiatric disorders; for example, elevated levels of cytokines and the inflammation-related transcription factor nuclear factor kappa-B (NF-κB) have been reported in individuals with autism spectrum disorder (ASD). The aim of this study was to investigate possible associati...

Clergy experience a large number of stressors in their work. In this context, resilience in the face of adversity is the result of low Harm Avoidance, high Persistence and high Self-Directedness. We found that, compared to the general population, only one in four Swedish clergymen/women had this specific personality profile.

Neurodevelopmental disorders, such as Autism Spectrum Disorders (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD), express aberrant neurocognitive functions in social communication, flexibility, and executive control from an early age, not seldom casting extensive consequences long into adulthood. They exist along a continuum from severe di...

In a sample of twins and their mothers we found, independent of zygosity, two clusters based on differences in the children’s (in)ability to be cooperative and self-directed and her/his level of reward dependence, together with differences in the mother’s levels of cooperativeness, self-directedness, reward dependence, and harm avoidance.

We examined the health effects of cultural activities and Well-Being Coaching among long-term unemployed Swedish young adults. While individuals receiving cultural activities only showed a slight decrease in anxiety, those receiving Well-Being Coaching showed significant increases in subjective well-being and decreases in depression, anxiety, and s...

Aggressive behaviour is of crucial importance in the defence for limited resources including food and mates and involves central serotonin as well as dopamine signalling. As ghrelin modulates food intake and sexual behaviour we initially investigated the hypothesis that central ghrelin signalling regulates aggressive behaviour in the resident intru...

With increasing numbers of children being diagnosed with neurodevelopmental disorders (NDDs) attention has been drawn to these children’s physical health. We aimed to identify the prevalence of defined physical problems (epilepsy, migraine, asthma, cancer, diabetes, psoriasis, lactose intolerance, celiac disease, diarrhea, constipation, daytime enu...

The original version of this article unfortunately contained a mistake in Fig. 2 part labels, the label “d” was incorrectly labelled as “c” and the subsequent labels should be corrected as d, e, and f. The corrected Fig. 2 is given below.

Previous research has found a complex relationship between psychopathic traits, neurodevelopmental problems (NDPs), and conduct disorder (CD) in children. This study explores associations between psychopathic traits, assessed with the Child Problematic Traits Inventory—Short Version (CPTI-SV), and CD in children with and without coexisting NDPs (i....

Poster presenting part of our results from the "physical health in children with neurodevelopmental disorders" project at the ESSENCE conference 2018

Objective: The Quantified Behavioral Test (QbTest) is a computerized diagnostic test for ADHD, used in clinical psychiatric care, but its validity may be questioned. We analyzed the QbTest’s diagnostic validity and its relation to cognitive ability and psychosocial factors in an adolescent population with a high occurrence of neurodevelopmental dis...

Background: Helping professionals have a working environment characterized by time pressure, unexpected challenges, and emotional issues [1]. According to statistics from The Swedish Social Insurance Agency, priests run a greater risk of being ill and burning out, which might impede their care for others due to stress and mental fatigue. Previous r...

Background Maternal smoking during pregnancy (MSDP) has been linked to offspring's externalizing problems. It has been argued that socio-demographic factors (e.g. maternal age and education), co-occurring environmental risk factors, or pleiotropic genetic effects may account for the association between MSDP and later outcomes. This study provides a...

Swedish priests, as a group, were high-average in self-directedness, high in cooperativeness, and high in self-transcendence. Self-directedness was associated to resilience and different measures of subjective well-being. Nevertheless, there was a large variation in character profiles that might have important implications for priests’ institutiona...

Callous-unemotional (CU) traits (e.g., lack of empathy, lack of guilt, shallow affect) are associated with severe and persistent conduct problems in youth. There is evidence showing a substantial genetic correlation between CU traits and conduct problems. The etiological associations between CU traits and other psychopathological symptoms, includin...

There is a need for instruments that can be used in correctional settings to measure changes in aggressive behaviors over a limited time period. This study aimed to validate an instrument (the Prison Adjusted Measure of Aggression, PAMA) that assesses specifically the past month's aggressive behaviors and is adapted for use in correctional faciliti...

Background: Reliable and easy to administer screening instruments focusing on neurodevelopmental disorders and associated conditions are scarce. The Autism-Tics, AD/HD and other Comorbidities inventory (A-TAC) has previously been validated and reporting good- excellent validity for several disorders. This article aims to expand these findings by i...

Background: Restrictive eating problems are rare in children but overrepresented in those with neurodevelopmental problems. Comorbidities decrease wellbeing in affected individuals but research in the area is relatively scarce. This study describes phenotypes, regarding psychiatric and gastrointestinal comorbidities, in children with restrictive e...

Genetic and environmental factors contribute to the etiologies of autism spectrum disorder (ASD), but evidence of specific environmental exposures and susceptibility windows is limited. Here we study monozygotic and dizygotic twins discordant for ASD to test whether fetal and postnatal metal dysregulation increases ASD risk. Using validated tooth-m...

Supplementary Figures and Supplementary Methods.

Background: Childhood aggressive antisocial behavior (CD) is one of the strongest predictors of mental health problems and criminal behavior in adulthood. The aims of this study were to describe personality profiles in children with CD, and to determine the strength of association between defined neurodevelopmental symptoms, dimensions of characte...

Neurodevelopmental disorders (Attention-Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), tic disorder, intellectual disability (ID)), in prison populations have received increased attention but the focus has generally been on one single condition leaving out the global picture. This study assessed the prevalence and overlap of...

Background The psychiatric health burden of prisoners is substantial. However, there is a lack of high-quality studies of psychiatric disorders among young adults with a high risk of reoffending. Aims To investigate the lifetime prevalence of psychiatric disorders and use of mental health services among young male violent offenders and the impact...

Gender specific personality profiles in association with the level of aggressive antisocial behavior in offenders have not been previously investigated. In the present study we analyzed data collected from 65 male and 50 female offenders using structured protocols regarding criminal history (by criminal register data), trait aggression (by the Life...

Table S1. The prevalence of six outcomes by ADHD at 15 and sex. Table S2. Odds ratios for psychosocial outcomes at age 15, crude and adjusted, by sex, OR (95% CI).

Background Antisocial personality and psychopathic traits have constantly been found to accompany criminal and aggressive behaviors, but little attention has been given to aspects of character maturity and its relation to such behaviors. The present study investigated (1) whether level of character maturity (low, medium, and high) is associated wit...

Objective: To examine the association between different levels of childhood attention deficit hyperactivity disorder (ADHD) symptoms and sex differences in psychosocial outcomes during adolescence. Method: Swedish children (n = 4635) were screened for neuropsychiatric symptoms at age 9 or 12. ADHD symptoms were divided into three levels: screen-...

Background: Forensic psychiatric patients present a challenge as they manifest severe mental disorders together with criminal behaviour. There are well-known risk factors for criminal behaviour in the general population, yet knowledge of what predicts reconviction in the Swedish forensic population in the long-term perspective is still insufficient...

The cover image, by Patrick D. Quinn, et al., is based on the Research Article Childhood Attention-Deficit/Hyperactivity Disorder Symptoms and the Development of Adolescent Alcohol Problems: A Prospective, Population-Based Study of Swedish Twins, DOI: 10.1002/ajmg.b.32412.

This 3-year follow-up study compares background variables, extent of criminality and criminal recidivism in the form of all court convictions, the use of inpatient care, and number of early deaths in Swedish institutionalized adolescents (N = 100) with comorbid substance use disorders (SUD) and Attention-Deficit/Hyperactivity Disorder (ADHD) (n = 2...

Early psychosocial adversities and maladjustment, such as childhood maltreatment and school adjustment problems, have been linked to an increased risk of aggressive antisocial behaviors. Yet, clinical studies of subjects at the highest risk of persistence in such behaviors are rare, especially during the life-changing transition years of emerging a...

Objective Attention-deficit/hyperactivity disorder (ADHD) is more frequent in males than in females. The “female protective effect” posits that females undergo greater exposure to etiological factors than males in order to develop ADHD, leading to the prediction that relatives of females with ADHD will display more ADHD behaviors. We thus tested wh...

Background: The character higher order scales (Self-directedness, Cooperativeness, and Self-transcendence) in the Temperament and Character Inventory are important general measures of health and well-being (Cloninger, 2013). Recent research has found suggestive evidence of common environmental influence on the development of these character traits...

Autism spectrum disorders (ASDs) are more prevalent in boys than in girls, indicating that high levels of testosterone during early development may be a risk factor. Evidence for this hypothesis comes from studies showing associations between fetal testosterone levels, as well as indirect measures of prenatal androgenization, and ASDs and autistic-...

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is more frequent in males than females. The ‘female protective effect’ posits that females undergo greater exposure to etiological factors than males in order to develop ADHD, leading to the prediction that relatives of females with ADHD will display more ADHD behaviors. We thus tested whet...

Despite increasing knowledge of attention deficit hyperactivity disorder (ADHD) across the life span, there is still little research on adults' own experiences of being diagnosed with ADHD. The aim of the present study was to explore and describe patients' experiences and perceptions of being diagnosed with ADHD in adulthood. The study can be seen...

Background: We used a computational method to quantitatively investigate the relationship between personality and written narratives of life events. Agentic (i.e., Self-directedness), communal (i.e., Cooperativeness), and spiritual (Self-transcendence) traits were of special interest because they represent individual differences in intentional valu...

Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of problematic alcohol and other substance use in adolescence. This study used data from an ongoing, prospective, population-based twin study of Swedish children and adolescents to evaluate the extent to which the association between ADHD symptoms and alcohol proble...

Abstract to AACAP 2015 Objective: The present study aimed to examine the effect of sex on the association between different levels of ADHD symptoms in childhood and a range of psychosocial outcomes in adolescence. So far, no one has done a similar study in this scale (N=4635), looking at both gender differences and subthreshold ADHD. Background: C...

The quantitative genetic contribution to antisocial behavior is well established, but few, if any, genetic variants are established as risk factors. Emerging evidence suggests that the neuropeptide oxytocin (OXT) may modulate interpersonal aggression. We here investigated whether single-nucleotide polymorphisms (SNPs) in the OXT receptor gene (OXTR...

Objective: Neurodevelopmental problems (NDPs) may influence the transition from childhood to adolescence. Our aim was to study long-term psychosocial outcomes of NDPs, focusing on ADHD. Method: Data was collected through a telephone interview with parents of twins at ages 9 or 12 years. NDP screen-positive children were clinically assessed at ag...

Background. A person-centered approach focusing on the interaction of an individual’s temperament-character-life events is essential in the path of individuals’ well-being. In this context, three character traits, Self-directedness (e.g., self-acceptance, self-control, goal-directed behavior), Cooperativeness (e.g., social affiliation, social toler...

Background. Over the last few decades, an increasing number of studies have suggested a connection between neurodevelopmental problems (NDPs) and body mass index (BMI). Attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) both seem to carry an increased risk for developing extreme BMI. However, the results are inconsi...

Background Cloninger’s psychobiological model defines personality as a self-organizing multidimensional complex adaptive system composed of temperament (i.e., individual differences in automatic responses to emotional stimuli) and character (i.e., individual differences in intentional goals and values). More recently, for instance, low levels of ch...

To compare the annual prevalence of the autism symptom phenotype and of registered diagnoses for autism spectrum disorder during a 10 year period in children. Population based study. Child and Adolescent Twin Study and national patient register, Sweden. 19 993 twins (190 with autism spectrum disorder) and all children (n=1 078 975; 4620 with autism...

Non-random selection into a study population due to differences between consenters and non-consenters may introduce participation bias. Past investigations of factors predicting consent to collection of medical health records for research imply that age, sex, health status, and education are of importance for participation, but disagree on the dire...

Background: Asthma and attention-deficit/hyperactivity disorder (ADHD) are prevalent in childhood and may cause functional impairment and stress in families. Previous research supports an association between asthma and ADHD in children, but several aspects of this relationship are unclear. Objective: Our aim was to study whether the association...

The purpose of the study was to evaluate time trends and effects of co-existing autism spectrum disorders (ASD) on outcome in an ongoing long-term follow-up study of anorexia nervosa (AN). The Morgan-Russell Outcome Assessment Schedule (MROAS) was used at 6-, 10- and 18-year follow-up of a representative sample of 51 individuals with teenage-onset...

It is rule rather than an exception that mental disorders occur in complex and manifold forms, and a number of models have been proposed to explain this co-occurrence or co-‘morbidity’. Autism spectrum disorders (ASD, i.e. autistic disorder, Asperger syndrome, and pervasive developmental disorder – not otherwise specified) are no exemption. Here, t...

Bully victimization is a common problem among children with neurodevelopmental disorders, including attention deficit/hyperactivity disorder and autism spectrum disorder. Previous research was mostly cross-sectional and seldom accounted for co-morbid psychopathology, which makes it difficult to draw conclusions about causality and specificity of an...

Autistic-like traits (ALTs) are continuously distributed in the general population, with the autism spectrum disorder (ASD) at the upper extreme end. A genetic overlap has been shown between ALTs and ASD, indicating that common variation in ASD candidate genes may also influence ALTs. In our study, we have investigated the SNP rs4307059 that has be...

Background Personality traits are important factors in predicting both development as well as remission of substance use disorders (SUDs). Self-directedness (SD) and cooperativeness (CO) are character personality traits on the Temperament-Character Inventory (TCI) that are modifiable and correlate with substance use. This association has not been s...

This volume is one of the few books to explain in-depth the international crimes behind the scenes of substantive or procedural law. The contributors place a particular focus on what motivates participation in international crime, how perpetrators, witnesses and victims see their predicament and how international crimes should be investigated at lo...

Background Evidence from twin and molecular genetic studies is accumulating that Autism Spectrum Disorder (ASD) shares substantial etiological factors with other disorders. This is mirrored in clinical practice where ASD without coexisting disorders is rare. The present study aims to examine the range of coexisting disorders in ASD in a genetically...

Background: Recent studies have reported associations between air pollution exposure and neurodevelopmental disorders in children, but the role of pre- and postnatal exposure has not been elucidated. Aim: We aimed to explore the risk for autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD) among children in relatio...

Objectives: The Brief Obsessive Compulsive Scale (BOCS), derived from the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) and the children's version (CY-BOCS), is a short self-report tool used to aid in the assessment of obsessive–compulsive symptoms and diagnosis of obsessive–compulsive disorder (OCD). It is widely used throughout child, adolescent...

- Introduction: The study of differences between monozygotic (MZ) twin pairs with respect to ADHD may provide novel leads to disentangle the environmental contribution driving its phenotypes. - Objectives: To examine non-shared environmental influences on executive function in dimensionally defined ADHD. - Methods: This study included 27 MZ twin pa...

Background Studies have found an association between low birth weight and ADHD, but the nature of this relation is unclear. First, it is uncertain whether birth weight is associated with both of the ADHD dimensions, inattentiveness and hyperactivity-impulsivity. Second, it remains uncertain whether the association between birth weight and ADHD symp...

Using a twin-sample, enriched with various types of mental health problems, we found that only one temperament trait (i.e., Persistence), was weakly related to IQ. Measures of agency (i.e, Self- directedness) and communion (i.e., Cooperativeness) were not. Hence, interventions targeting agentic and communal behaviour should not be limited by variat...

Background Children with early symptomatic psychiatric disorders such as Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) have been found to have high rates of motor and/or perception difficulties. However, there have been few large-scale studies reporting on the association between Conduct Disorder (CD) and motor/...

Neurobiological determinism has characterized later decades’ scientific approaches to the notion of free will. Scientists suggest that legal responsibility should be adjusted accordingly. We measured the genetic and environmental effects behind self-reported Self-directedness and Cooperativeness in a nation-wide population-based adolescent twin stu...

Rates of recidivism and types of recidivist crime have varied greatly in follow-up studies of child sexual abusers. In this long-term study of a population-based cohort (n = 193) and a nationwide clinic-referred study group (n = 166) of child sexual abusers, rates of recidivism and associations between index descriptors and outcomes were compared b...

Background Life stories emphasize the narrative and self-organizing aspects of human behaviors and complement personality traits in explaining human identity. In contrast to most research on narratives in which the analysis is restricted to the researcher’s subjective evaluations and interpretations, we used computational methods to quantitatively...

Cloninger’s model of personality comprises four temperament (Novelty Seeking, Harm Avoidance, Reward Dependence, and Persistence) and three character dimensions (Self-directedness, Cooperativeness, and Self-transcendence). These dimensions are associated to attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD). Specifi...

Background. Previous research has supported gender-specific aetiological factors in oppositional defiant disorder (ODD) and conduct disorder (CD). The aims of this study were to identify gender-specific associations between the behavioural problems–ODD/CD-like problems–and the neurodevelopmental disorders–attention deficit hyperactivity disorder (A...

Neurodevelopmental disorders affect a substantial minority of the general population. Their origins are still largely unknown, but a complex interplay of genetic and environmental factors causing disturbances of the central nervous system's maturation and a variety of higher cognitive skills is presumed. Only limited research of rather small sample...

Autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD) show high comorbidity. The following questions were addressed regarding their specific symptoms: What is the factor structure of ASD and ADHD symptoms, to what degree do different symptom domains cluster together, to what extent are these domains caused by the same...

Oxytocin has repeatedly been shown to influence human behavior in social contexts; also, a relationship between oxytocin and the pathophysiology of autism spectrum disorder (ASD) has been suggested. In the present study, we investigated single-nucleotide polymorphisms (SNPs) in the oxytocin gene (OXT) and the genes for single-minded 1 (SIM1), aryl...

Background: The Brief Obsessive Compulsive Scale (BOCS), derived from the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the children's version (CY-BOCS), is a short self-report tool used to aid in the assessment of obsessive-compulsive symptoms and diagnosis of obsessive-compulsive disorder (OCD). It is widely used throughout child, adolescen...

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Offenders with high psychopathic traits and/or antisocial personality disorder (ASPD) are hypothesised to experience less guilt and less responsibility for their actions than offenders without these problems. These hypotheses were tested and partly substantiated. The study investigates blame attributions and guilt feeling using Gudjonsson Blame Att...

The Autism-Tics, AD/HD, and other Comorbidities (A-TAC) inventory is used in epidemiological research to assess neurodevelopmental problems and coexisting conditions. Although the A-TAC has been applied in various populations, data on retest reliability are limited. The objective of the present study was to present additional reliability data. The...

Non-neurological surgery has both acute and long-term effects on the brain. Markers for Alzheimer pathology may be used to study surgically induced neurological changes relevant for postoperative confusion, asthenia or cognitive decline. Inflammatory biomarkers, total tau (T-tau) and phosphorylated tau (P-tau) were recently shown to increase progre...

Ever since its historical beginnings during or after the French Revolution, psychiatric pioneers claimed expertise in the field of crime and punishment. Theirs was a humanistic stance directed against the cruel punishments that were considered ‘just’ and ‘necessary’ by their time. Their drive was the Enlightenment world-view, a revolutionary zest f...

Widespread abnormalities in white matter development are frequently reported in cases of autism spectrum disorders (ASD) and could be involved in the disconnectivity suggested in these disorders. Homozygous mutations in the gene coding for fatty-acid 2-hydroxylase (FA2H), an enzyme involved in myelin synthesis, are associated with complex leukodyst...

To the best of our knowledge, the present register is the only nationwide forensic psychiatric patient register in the world. The aim of this article is to describe the content of the Swedish National Forensic Psychiatric Register (SNFPR) for Swedish forensic patients for the year 2010. The subjects are individuals who, in connection with prosecuti...

Population-based studies on violent crime and background factors may provide an understanding of the relationships between susceptibility factors and crime. We aimed to determine the distribution of violent crime convictions in the Swedish population 1973-2004 and to identify criminal, academic, parental, and psychiatric risk factors for persistenc...