The theoretical underpinnings of affective temperaments: implications for evolutionary foundations of bipolar disorder and human nature

Combining predominant polarity and affective spectrum concepts in bipolar disorder: towards a novel theoretical and clinical perspective

This is an overview of recent advances on predominant polarity conceptualization in bipolar disorder (BD). Current evidence on its operationalized definitions, possible contextualization within the affective spectrum, along with its epidemiological impact, and treatment implications, are summarized. Predominant polarity identifies three subgroups of patients with BD according to their mood recurrencies: (i) those with depressive or (ii) manic predominance as well as (iii) patients without any preponderance ('nuclear' type). A predominant polarity can be identified in approximately half of patients, with similar rates for depressive and manic predominance. Different factors may influence the predominant polarity, including affective temperaments. More generally, affective disorders should be considered as existing on a spectrum ranging from depressive to manic features, also accounting for disorders with 'ultrapredominant' polarity, i.e., unipolar depression and mania. While mixed findings emerge on its utility in clinical practice, it is likely that the construct of predominant polarity, in place of conventional differentiation between BD-I and BD-II, may be useful to clarify the natural history of the disorder and select the most appropriate interventions. The conceptualization of predominant polarity seems to reconcile previous theoretical views of both BD and affective spectrum into a novel perspective. It may provide useful information to clinicians for the early identification of possible trajectories of BD and thus guide them when selecting interventions for maintenance treatment. However, further research is needed to clarify the specific role of predominant polarity as a key determinant of BD course, outcome, and treatment response.

Neural substrates of affective temperaments: An intersubject representational similarity analysis to resting-state functional magnetic resonance imaging in nonclinical subjects

Previous research has suggested that certain types of the affective temperament, including depressive, cyclothymic, hyperthymic, irritable, and anxious, are subclinical manifestations and precursors of mental disorders. However, the neural mechanisms that underlie these temperaments are not fully understood. The aim of this study was to identify the brain regions associated with different affective temperaments. We collected the resting-state functional magnetic resonance imaging (fMRI) data from 211 healthy adults and evaluated their affective temperaments using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire. We used intersubject representational similarity analysis to identify brain regions associated with each affective temperament. Brain regions associated with each affective temperament were detected. These regions included the prefrontal cortex, anterior cingulate cortex (ACC), precuneus, amygdala, thalami, hippocampus, and visual areas. The ACC, lingual gyri, and precuneus showed similar activity across several affective temperaments. The similarity in related brain regions was high among the cyclothymic, irritable, and anxious temperaments, and low between hyperthymic and the other affective temperaments. These findings may advance our understanding of the neural mechanisms underlying affective temperaments and their potential relationship to mental disorders and may have potential implications for personalized treatment strategies for mood disorders.

Predominant affective temperaments in depressive patients with severe social withdrawal

BACKGROUND

Hikikomori (HK) is characterized by self-isolation and social refusal, being more likely also associated with affective disorders, including depression. This case-control study primarily aimed at identifying (if any) predominant affective temperaments are associated with HK in depressed versus not-depressed individuals. Secondary objectives comprise assessing which other psychopathological dimensions (e.g., boredom, anxiety) are associated with the HK specifier in depressed individuals.

METHODS

From the larger SWATCH study, 687 Italian young people were screened for depression, as measured by 9 items-Patient Health Questionnaire (PHQ-9) and HK-like social withdrawal, through the Hikikomori Questionnaire-25 (HQ-25). All subjects were administered a brief-Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-M), the 7 items-Generalized Anxiety Disorder (GAD-7) and the Multidimensional State Boredom Scale (MSBS).

RESULTS

Males reported significantly higher scores at HQ-25 total score than females (p = 0.026). In the total sample, HK social withdrawal is positively predicted by MSBS low arousal, disengagement, depressive levels, depressive and irritable affective temperaments, while negatively by anxiety (F(6, 680) = 82.336, p < 0.001, R2 = 0.421). By selecting only depressed sample, HQ-25 is positively predicted by MSBS total score, low arousal and depressive affective temperament, while negatively by MSBS high arousal (F(4, 383) = 48.544, p < 0.001, R2 = 0.336). The logistic regression model found that the likelihood of developing depression with the HK specifier is significantly predicted by depressive and cyclothymic affective temperaments.

CONCLUSIONS

These preliminary findings could help in clinically characterizing the relationship between specific affective temperamental profiles among individuals with depression with/without HK specifier, in order to provide a more tailored and personalized therapeutic approach. Our Italian study should be extensively replicated in larger, longitudinal and multicentric pan-European studies, by specifically assessing the impact of these findings on depression clinical course, prognosis and treatment outcomes.

Affective temperaments show stronger association with infertility treatment success compared to somatic factors, highlighting the role of personality focused interventions

Infertility has a multifactorial background, where, besides somatic factors, psychological contributors also play a role in development and outcome. While affective temperaments have been associated with development, course, and outcome as well as treatment success in various somatic conditions, their association with infertility and its treatment has not been investigated so far. The purpose of our retrospective cohort study was to evaluate the influence of affective temperaments on fertility treatment outcomes. Among 578 women who underwent infertility treatment in an Assisted Reproduction Centre in Budapest, Hungary, treatment success, detailed medical history, and demographic parameters were recorded, and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A) was administered. Possible predictors of assisted reproduction outcome were analyzed using multivariate logistic regression models, followed by a receiver operating curve (ROC) analysis in order to define ideal affective temperament cut-off values for clinical applicability. Aside from age, BMI, and previous miscarriage, cyclothymic scores > 4 (OR = 0.51 CI 0.35-0.74, p < 0.001), depressive scores > 9 (OR = 0.59 CI 0.4-0.87, p = 0.009) and anxious scores > 9 (OR = 0.45 CI 0.31-0.66, p < 0.001) significantly decreased the odds of clinical pregnancy by 49%, 41% and 55%, respectively. Irritable and hyperthymic temperaments, as well as other somatic and socio-economic factors had no effect on infertility treatment outcomes. The results suggest that affective temperaments may be related to the outcome of infertility treatments. Thus, screening for affective temperaments may help identify high-risk patient groups and offer patient-tailored treatment, which may increase the chances of a successful pregnancy and live birth for women undergoing IVF treatment.

'Personality and bipolar disorder: personality profiles of patients with remitted bipolar disorder and matched controls in a Danish sample'

BACKGROUND

The aim of the study was to investigate whether patients with bipolar disorder (BD) in remission differ in personality traits compared with a healthy control group.

METHODS

A sample of patients with BD (n = 44) was compared with an individually matched control group (n = 44) using the Danish version of the Revised NEO Personality Inventory (NEO PI-R). Paired t-tests were used to analyze differences between the two groups and multiple regression models to evaluate predictors of NEO scores in the patient group.

RESULTS

Patients with BD reported significantly higher scores on both Neuroticism and Openness to Experience and lower scores on Conscientiousness. No differences were found on Extraversion and Agreeableness. The effect size for Neuroticism and its facets had a range from 0.77 to 1.45 SD.Statistically significant group differences were seen on 15 of 30 lower-level traits within all five high-order dimensions. There were large effect sizes for Trust (0.77) and Self-discipline (0.85), while the other statistically significant group differences were smaller with effect sizes in the range from 0.43 to 0.74 SD.However, patients with BD showed a profile with high-order dimensions and lower-level traits within one standard deviation from the mean score except for the lower-level trait Depression.

CONCLUSIONS

Our findings suggest that patients with BD differ from healthy control persons with respect to higher levels of Neuroticism, Openness to Experience and lower scores on Agreeableness and on Conscientiousness, but prospective studies are needed to evaluate the implications of this finding.

Effect of affective temperament on illness characteristics of subjects with bipolar disorder and major depressive disorder

BACKGROUND

Affective temperaments represent the stable, biologically determined substrates of mood disorders. The relationship between affective temperaments and bipolar disorder (BD) or major depressive disorder (MDD) has been described. However, the strength of such relationship should be tested while considering other factors influencing the diagnosis of BD/MDD. Literature also lacks a comprehensive description of the interplay between affective temperament and characteristics of mood disorders. The aim of the present study is to address these issues.

METHODS

This is a multicentric observational study including 7 Italian university sites. Five-hundred-fifty-five euthymic subjects with BD/MDD were enrolled and further divided in those with hyperthymic (Hyper, N = 143), cyclothymic (Cyclo, N = 133), irritable (Irr, N = 49), dysthymic (Dysth, N = 155), and anxious (Anx N = 76) temperaments. Linear, binary, ordinal and logistic regressions were performed to assess the association between affective temperaments and i) diagnosis of BD/MDD; ii) characteristics of illness severity and course.

RESULTS

Hyper, Cyclo and Irr were more likely to be associated with BD, together with earlier age of onset and presence of a first-degree relative with BD. Anx and Dysth were more associated with MDD. Differences in association between affective temperaments and characteristics of BD/MDD were observed for hospital admissions, phase-related psychotic symptoms, length and type of depression, comorbidity and pharmacological intake.

LIMITATIONS

Small sample size, cross-sectional design, recall biases.

CONCLUSION

Specific affective temperaments were associated to certain characteristics of illness severity and course of BD or MDD. Evaluation of affective temperaments might help a deeper understanding of mood disorders.

The Expression of Affective Temperaments in Cystic Fibrosis Patients: Psychopathological Associations and Possible Neurobiological Mechanisms

The aim of this study was to investigate the association between Cystic Fibrosis (CF) and affective temperaments, considering the relevance of ionic balances in neural excitability, as a possible neurobiological basis for temperamental expression. A cross-sectional study involving 55 adult CF patients was conducted. Sociodemographic, clinical and therapeutic characteristics, temperamental and personality dispositions and depressive and anxiety symptoms were evaluated through standardized semi-structured and structured interviews. The majority of the enrolled CF patients were receiving Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) therapy (72.7%), and most of them had hyperthymic temperament predominance (29.1%). Different TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire) dimensions were not associated with the type of CF phenotype-related mutation or with the use of CFTR-modulator therapy. However, a tendency towards irritability was noted in patients not undergoing CFTR modulator therapy (6.7 ± 4.72 vs. 4.7 ± 4.33; p = 0.13). In light of the limitations imposed by the cross-sectional nature of the study, a hyperthymic temperament was found to be protective against current or lifetime psychopathologic events, whereas the other temperaments were associated with positive psychopathological anamnesis. Based on the measurement of temperament profiles and the study of their associations with clinically relevant variables, we argue that subjecting CF patients to such a temperament assessment could prove beneficial in the transition towards integrated and personalized care.

The association between affective temperaments and insomnia as mediated by satisfaction with life: a cross-sectional study

Background

The primary objectives of this study were to examine whether affective temperaments are associated with satisfac-tion with life; to determine whether satisfaction with life can mediate the relationship between affective tempera-ments and insomnia; and to reaffirm the relationship between affective temperaments and insomnia. We hypothe-sized that affective temperaments were associated directly and indirectly via satisfaction with life with insomnia.

Participants and procedure

A total of 497 participants aged 18 to 67 years, including 435 women and 62 men, were recruited from the general population via an online recruitment platform. We used the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Autoquestionnaire to evaluate affective temperaments and the Satisfaction with Life Scale to assess satis-faction with life. The Athens Insomnia Scale was used to assess participants’ level of insomnia symptoms.

Results

Depressive, cyclothymic, irritable and anxious temperaments correlated positively with insomnia symptoms, but hyperthymic temperament correlated negatively with insomnia symptoms. Satisfaction with life correlated negative-ly with insomnia symptoms. Hyperthymic temperament correlated positively with satisfaction with life, but depres-sive, cyclothymic, irritable and anxious temperaments correlated negatively with satisfaction with life. Hierarchical regression analysis indicated that 30% of the variance in insomnia symptoms was attributable to satisfaction with life level and the presence of cyclothymic and anxious temperaments. The mediation analysis suggested a significant indirect effect of cyclothymic and anxious temperaments on insomnia through satisfaction with life as a mediator between affective temperaments and insomnia.

Conclusions

Cyclothymic and anxious temperaments can influence the symptoms of insomnia directly and indirectly as mediated by satisfaction with life.

Validation of the Arabic version of the 35-item TEMPS-M in a community sample of adults

BACKGROUND

To our knowledge, no brief version of the Temperament Evaluation in Memphis Pisa and San Diego (TEMPS-M) is available so far in the Arabic language, which might have resulted in limited research in this field from Arab countries. We aimed through this study to validate the 35-item TEMPS-M into the Arabic language in a sample of non-clinical Lebanese adults.

METHODS

We used an online cross-sectional survey targeting non-clinical Lebanese adults from the general population. A confirmatory factor analysis was conducted to test the factorial structure of the TEMPS-M.

RESULTS

All five temperament subscales achieved good/very good internal consistencies in the present study (depressive: α = 0.78, cyclothymic: α = 0.86, hyperthymic: α = 0.83, irritable: α = 0.87, and anxious: α = 0.87). The five-factor solution of the TEMPS-M displayed a good CFI of 0.94, TLI of .94 and a GFI of .95, but a poor RMSEA of .10 [90% CI .10, .11]. The five affective temperaments showed positive correlations with personality dysfunction domains, thus attesting for convergent validity. In addition, positive correlations between all affective temperament dimensions and anxiety/depression scores were found. We also tested for gender invariance, and found that configural, metric, and scalar invariance were supported across gender.

CONCLUSION

Our data suggest that the psychometric properties of the Arabic TEMPS-M are good. Making this scale available in Arabic will hopefully encourage Arab researchers to investigate this under-explored topic in their countries, and advance knowledge on how culture impacts the prevalence, development and course of temperament.

The association between affective temperaments and depressive symptoms in a population of medical university students, Poland

Background

Compared to their peers, medical students are more exposed to stress, and many present symptoms of depression, making them a group prone to experiencing mental illnesses.

Objective

This study investigates a potential link between the occurrence of symptoms of depression and the dominating type of affective temperament in young people studying at a medical university.

Methods

One hundred thirty-four medical students were surveyed using two validated questionnaires; the Polish versions of Beck's Depression Inventory-II (BDI-II) and the Temperament Evaluation of the Memphis, Pisa, and San Diego Autoquestionnaire (TEMPS-A).

Results

The data analysis revealed a significant link between symptoms of depression and affective temperaments, most significantly in subjects with an anxious temperament.

Conclusion

This study confirms the role of various affective temperaments as a risk factor for mood disorders, specifically depression.

Investigation of the relationship between early maladaptive schemas, temperament and eating attitude in adults

BACKGROUND

Current research on eating attitude has focused primarily on female perspective (Kapoor et al. in J Educ Health Promot 11(80):1-7, 2022; Piko et al. in J Prev Med Hyg. 63(1):83-89, 2022). To extend cross-gender approaches, this study aimed to examine the relationship between early maladaptive schemas, temperament, and eating attitude and to see whether these three concepts differ between men and women.

METHODS

The sample group consists of a total of 308 participants, 206 (66.9%) women and 102 (33.1%) men, living in Bursa and participating in the research voluntarily. In the study, Sociodemographic Data Form was used to obtain personal information of the participants, Young Schema Questionnaire-Short Form 3 was used to evaluate early maladaptive schemas, Temperament Evaluation of Memphis, Pisa, Paris and San-Diego Autoquestionnaire was used to evaluate temperament characteristics and Eating Attitude Test was used to evaluate eating attitudes.

RESULTS

As a result of the study, a moderate and positive relationship was found between the Defectiveness, Emotional Inhibition, Enmeshment/Dependence, Failure, Abandonment, Vulnerability to Harm or Illness, Negativity/Pessimism schemas and eating attitude. Among these schemas, Defectiveness was found to be the best predictor of deterioration in eating attitude. A weak and positive relationship was found between the scores obtained from the Eating Attitude Test and Cyclothymic and Irritable temperaments, and a moderate positive relationship with Anxious temperament. Among these temperaments, Anxious temperament was found to be the best predictor of deterioration in eating attitude.

CONCLUSIONS

When the results were examined, a relationship was observed between early maladaptive schemas and temperament types, and this relationship was examined in detail. The results obtained at the end of the study were discussed and suggestions were made for future studies.

Affective temperament and mood spectrum symptoms in workers suffering from work-related stress disorders

INTRODUCTION

Adjustment Disorders (AD) which develop in response to work-related stressors represent a model of psychiatric occupational disease. Major Depressive Episodes (MDE) although often associated to work-related stressors are unlikely recognized by insurance institutes as occupational diseases. Affective temperament and mood spectrum symptoms are possible factors of vulnerability to stress. The aim of this study was to investigate if temperaments and mood spectrum symptoms had a different distribution among workers exposed to occupational stress and suffering from different psychiatric disorders (AD, MDE).

METHODS

156 AD and 97 MDE patients were recruited and evaluated with scales for perceived stress (PSM) and work-related stress (JCQ), for psychopathological symptoms (BDI-II, SAS), for affective temperament (TEMPS-A[P]) and for lifetime mood spectrum symptoms (MOODS-SR). Group comparisons and correlation analyses between variables were performed by parametric or non-parametric statistical tests according to variables distribution.

RESULTS

The diagnostic groups did not differ for perceived and occupational stress levels. MDE patients reported significantly higher BDI-II score and MOODS-SR scores than AD ones. The hyperthymic temperament was significantly more frequent in AD than in MDE group. The hyperthymic score, differently from other dimensions of temperament and from mood spectrum components, negatively correlated or did not correlate with psychopathological symptoms severity and perceived stress levels.

LIMITATIONS

Predictive limitation because of cross-sectional design.

CONCLUSIONS

The hyperthymic temperament as opposed to lifetime subtreshold mood symptoms appears to be more represented in patients suffering from occupational AD than in MDE ones. Acknowledging vulnerability factors to job stress could support clinicians in occupational diseases prevention and management.

Effects of SARS-CoV-2 infection and COVID-19 pandemic on menstrual health of women: A systematic review

Background

The menstrual cycle in women is the main indicator of their reproductive health which is affected by the ongoing coronavirus disease 2019 (COVID-19) pandemic. This review aims to summarize the effects of the COVID-19 infection and the global pandemic on the menstrual health of women.

Methods

The literature search was conducted in PubMed, Cochrane library, and Google Scholar using keywords "COVID-19," "Menstrual Cycle," "Menstrual Cycle Irregularities," "Amenorrhea," "Polymenorrhea," and "Dysmenorrhea." The articles were selected according to the following inclusion criteria: (i) cross-sectional studies, (ii) cohort studies, (iii) surveys, and (iv) other observational studies observing the effects of SARS-CoV-2 infection or COVID-19 pandemic on menstrual health of women. Exclusion criteria included: case reports, gray literature, and website articles regarding menstrual health.

Results

A total of 30,510 articles were shortlisted after a comprehensive search. Sixteen articles were included out of which 13 studies investigated the effects of the COVID-19 pandemic on the menstrual cycle while 3 evaluated the possible effects of COVID-19 infection on the menstrual health of women. Menstrual disorders or irregularities were a more common finding during the pandemic as compared to before (p = 0.008). Women affected by pandemic-related stress were more prone to changes in the duration of their menses (p = 0.0008), reported heavier bleeding (p = 0.028), and increased incidence of painful periods (p < 0.0001). COVID-19 infected women also reported changes in their menstrual cycle including irregular menstruation, increased symptoms of premenstrual syndrome, and infrequent menstruation.

Conclusions

Women suffering from COVID-19 infection or pandemic-associated stress and anxiety were more likely to experience irregular menstruation, dysmenorrhea, amenorrhea, and other menstrual abnormalities compared to those who were less exposed.

Cyclothymic affective temperament is independently associated with left ventricular hypertrophy in chronic hypertensive patients

OBJECTIVE

Affective temperaments (depressive, anxious, irritable, hyperthymic, and cyclothymic) are regarded as the stable core of personality and when present in their dominant form, are considered subclinical manifestations and high-risk states for various affective disorders. Furthermore, cumulating evidence supports their relationship with cardiovascular diseases. Our aim was to assess the association between affective temperaments and left ventricular hypertrophy (LVH) in chronic hypertensive patients.

METHODS

In the present cross-sectional study, 296 patients referred to coronary computed tomography angiography (CCTA) due to suspected coronary artery disease were analyzed. All patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A). Left ventricular mass was quantified by CCTA and indexed to the body surface area (LVMi). Logistic regression analysis was used to identify predictors of LVH (men: ≥67.2 g/m² and women: ≥54.7 g/m²).

RESULTS

Among our patient cohort (mean age: 59.4 ± 10.6, 44.9% female), the median LVM and LVMi were 115.5 [88.4-140.7] g and 58.4 [47.4-64.2] g/m², respectively. Elevated BMI (OR = 1.04 CI: 1.01-1.10, p = 0.04) and cyclothymic affective temperament scores (OR = 1.06 CI: 1.00-1.12, p = 0.04) significantly increased the odds of LVH in multivariate logistic regression analysis.

CONCLUSION

Assessment of affective temperaments may allow for the identification of chronic hypertensive patients with elevated risk for LVH as a potential target for earlier primary intervention.

Korean Validation of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire

OBJECTIVE

The Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) has been validated in more than 30 languages and is noted for its broad application in research and clinical settings. This study presents the first attempt to examine the reliability and validity of the TEMPS-A in Korea.

METHODS

A total of 540 non-clinical participants completed the Korean TEMPS-A, which was adapted from the original English version via a comprehensive translation procedure. Reliability was assessed using Cronbach's α, and associations between temperaments were examined using Spearman's correlation coefficient. Exploratory factor analysis (EFA) was performed, and differences in TEMPS-A scores between the gender- and age-based groups were examined using Kruskal-Wallis analysis.

RESULTS

The Korean TEMPS-A exhibited excellent internal consistency (0.70-0.91) and significant correlations between subscales. EFA resulted in a two-factor structure: Factor I (depressive, cyclothymic, irritable, and anxious) and Factor II (hyperthymic). Gender and age group differences were observed.

CONCLUSION

Overall, our results suggest that TEMPS-A is a reliable and valid measure of affective temperaments for the Korean population. This study opens new possibilities for further research on affective temperaments and their related traits.

Temperaments and orthorexia nervosa: a cross-cultural study between Germany and Lebanon

The aim of this study was to explore the association between affective temperaments and orthorexic eating and whether temperament may explain cross-cultural differences in this behavior while considering the two dimensions of orthorexic eating, healthy (HeOr) and nervosa (OrNe). To accomplish this, 337 and 389 individuals were recruited in Lebanon and Germany, respectively. The brief version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego explored depressive, hyperthymic, cyclothymic, anxious and irritable temperaments, and the Teruel Orthorexia scale explored orthorexic eating. HeOr appeared comparable between countries but OrNe was higher in Lebanon. In terms of affective temperaments, the higher the depressive, cyclothymic, irritable, and anxious temperaments, the higher were the levels of OrNe. Only the hyperthymic temperament scale was positively associated with HeOr. Three-step regression analysis indicated only gender as a unique predictor for HeOr. By contrast, gender, depressive, hyperthymic, and anxious temperament as well as the two-way interactions country*depressive temperament and country*hyperthymic temperament were significant predictors of OrNe. The positive association between OrNe and depressive temperament was only found for the German sample while the negative association between hyperthymic temperament and OrNe was somewhat stronger in the Lebanese sample. Overall, a higher healthy interest in diet was linked to the hyperthymic temperament. Findings emphasized the role of temperaments in pathological orthorexic eating in general as well as in explaining cross-cultural differences in these behaviors. The assessment of temperaments could help to fit treatments for eating pathologies to individuals from different cultures, focusing interventions more on these aspects.

Comparison of the relative sensitivity of two dimensional personality models to the psychopathological symptoms: the section III DSM-5 maladaptive traits versus affective temperaments

BACKGROUND

The Personality Inventory for DSM-5 (PID-5) and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) are tools designed for personality dispositions for mental health symptoms. The present study was conducted to compare these models in terms of their relative sensitivity to the symptoms of personality disorders (PDs) and non-personality disorders (NPDs).

METHODS

Subjects in this cross-sectional study were 1232 (805 female; 63.5%) community samples in western Iran. Data were collected using the PID-5, the TEMPS-A, the Symptom Checklist-90 (SCL-90-R), and the Personality Diagnostic Questionnaire (PDQ-4). Correlations and Regression models were used to examine associations between traits and symptoms.

RESULTS

Maladaptive traits assessed by the PID-5 were more strongly associated with PD symptoms, whereas affective temperaments measured by the TEMPS-A were more strongly associated with NPD symptoms.

CONCLUSION

The present findings highlighted the practical utility of both the PID-5 and TEMPS-A indicating risk for psychopathology, but also suggest a distinction between PDs and NPDs in terms of underlying personality dispositions.

Emotion Dysregulation and Affective Temperaments in Opioid Use Disorder: the preliminary results of a prospective study

BACKGROUND

Substance use disorder is a growing health problem all over the world. The coexistence of substance misuse, affective temperaments, and emotion dysregulation has not been studied sufficiently.

OBJECTIVE

The present study aimed to evaluate the role of affective temperaments and emotion dysregulation on substance use disorder. The Emotion Dysregulation and Affective Temperaments in Opioid Use Disorder study was designed observational. This paper presents only the baseline assessments of the patient and control groups. One-year remission rates of the patients' group will be reported elsewhere after 1-year follow-up.

METHODS

Sixty-seven patients with opioid use disorder and 68 healthy controls enrolled. All participants were administered to The Structured Clinical Interview for DSM-5, Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire, Difficulties in Emotion Regulation Scale, Beck Anxiety Inventory, and Beck Depression Inventory.

RESULTS

Patients with opioid use disorder had higher scores from all temperamental scales and showed higher difficulties on emotion regulation than the control group. Even controlling the confounding effects of anxiety and depression levels, dysthymic and anxious temperament scores were found correlated with the emotion dysregulation score in the patient group.

CONCLUSIONS

The emotional traits (i.e., affective temperaments) and emotion regulation abilities play a crucial role in substance use disorder. While managing substance use disorder, being aware of affective temperament characteristics and/or interventions to improve emotion regulation skills may be helpful.

Specialised minds: extending adaptive explanations of personality to the evolution of psychopathology

Traditional evolutionary theory invoked natural and sexual selection to explain species- and sex-typical traits. However, some heritable inter-individual variability in behaviour and psychology - personality - is probably adaptive. Here we extend this insight to common psychopathological traits. Reviewing key findings from three background areas of importance - theoretical models, non-human personality and evolved human social dynamics - we propose that a combination of social niche specialisation, negative frequency-dependency, balancing selection and adaptive developmental plasticity should explain adaptation for individual differences in psychology - 'specialised minds' - explaining some variance in personality and psychopathology trait dimensions, which share various characteristics. We suggest that anthropological research of behavioural differences should be extended past broad demographic factors (age and sex) to include individual specialisations. As a first step towards grounding psychopathology in ancestral social structure, we propose a minimum plausible prevalence, given likely ancestral group sizes, for negatively frequency-dependent phenotypes to be maintained as specialised tails of adaptive distributions - below the calculated prevalence, specialisation is highly unlikely. For instance, chronic highly debilitating forms of autism or schizophrenia are too rare for such explanations, whereas attention-deficit-hyperactivity disorder and broad autism phenotypes are common enough to have existed in most hunter-gatherer bands, making adaptive explanations more plausible.

Are Affective Temperaments, Emotional Abuse, and Neglect Involved in Mentalization Abilities in Patients With Psychiatric Disorders?

Patients who have experienced emotional abuse and neglect often develop psychiatric disorders in adulthood. However, whether emotional abuse, neglect, and mentalization abilities relate to one another and the role of possible mediators of this relationship in psychiatric patients are still unknown. We evaluated the potential role of affective temperament as a mediator of the relationship between emotional abuse and neglect and mentalization. We performed a cross-sectional study of 252 adult psychiatric inpatients. The Childhood Trauma Questionnaire, Mentalization Questionnaire, and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) were administered. Results showed a significant indirect effect of emotional abuse and neglect on scores on the Mentalization Questionnaire through the TEMPS-A (b = 0.25, 95% confidence interval [0.143-0.375]), demonstrating that affective temperament mediates the relationship among emotional abuse, neglect, and mentalization impairment in psychiatric patients. A careful evaluation of mentalization abilities in patients with psychiatric disorders and who have a history of emotional abuse and neglect is necessary for a better understanding of psychopathology and for the choice of therapeutic strategies.

Sex differences in maturation and aging of human personality on the basis of a recently developed complex hierarchical model of temperament and character

OBJECTIVE

The current study aimed to determine the changes in psychological function that come with age. The basis to assess psychological function was a hierarchical model of temperament, personality and character, previously developed by the authors.

METHODS

734 general population subjects completed the TEMPS-A, the TCI and the NEO-PI-3. Data were analysed with ANCOVA models.

RESULTS

The top superfactors showed no age change, however, age-related changes were identified in the higher and lower modules. There was a pattern of differences between the two genders in all levels of the model.

CONCLUSIONS

While there is stability with the two top factors of personality, there are age-related changes in lower-level modules probably indicating maturation, adaptation or changes in orientation through the adult life span. Gender differences in all levels including the two top superfactors, higher and lower modules reflect and explain differences in multiple aspects of internal experience, interaction and behaviour in the two genders. The results are clinically essential for incorporating age and gender-related differences of experience and behaviour in understanding temperamental implications in affective disorders also impacting their clinical course and management.Key PointsBased on the complex hierarchical temperament model four stages of maturation of human psychological function can be postulated.There is a very specific trait core of human mental function, which differs between genders and seems to be responsible for the longitudinal stability of the person's internal experience with the passing of the years.The findings are clinically essential for incorporating age and gender-related differences of experience and behaviour in understanding temperamental implications in affective disorders also impacting their clinical course and management.

Affective temperaments and the risk of gestational diabetes mellitus

OBJECTIVE

Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy. The current study aimed to investigate the possibility of a relationship between affective temperaments and GDM.

METHODS

This ethically approved cross-sectional study was conducted on 120 pregnant women with impaired glucose tolerance and 120 healthy pregnant women, all of whom were admitted to hospitals affiliated with Mashhad University of Medical Sciences for delivery during 2019. Depression Anxiety Stress Scale (DASS)-21 and Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto-questionnaire (TEMPS-A) were used to gather data. Mann-Whitney test was used to compare data between the two groups. A multivariate binary logistic regression model with maternal age, body mass index, and multiparity as the covariates was used to assess factors associated with GDM.

RESULTS

Outcomes of TEMPS-A showed significantly higher scores of anxious and irritable temperaments in the GDM group compared to the control group (p = 0.014 and 0.023, respectively). Multivariate regression showed anxious temperament to be the sole independent predictor of GDM (odds ratio = 1.09, 95%confidence interval = 1.030-1.153; p = 0.003). DASS-21 anxiety score was also significantly higher among patients with GDM (p = 0.002). Severity of anxiety and stress according to DASS-21 was also significantly greater in patients with impaired glucose tolerance (p < 0.001 and p = 0.016, respectively).

CONCLUSIONS

It is ostensible that affective temperaments, especially anxious temperament, are potentially associated with the development of GDM and impaired glucose metabolism during pregnancy.Key pointsThe association of affective temperaments with pregnancy complications has drawn compelling interest.The findings of this study showed significantly higher scores of anxious and irritable temperaments in GDM patients.GDM patients also showed significantly higher levels of anxiety compared to controls.Predominance of anxious temperament can be a potential risk factor that contributes to the development of GDM.Monitoring for GDM is especially recommended in pregnant women with predominant anxious and irritable temperaments.

Affective temperaments and sexual functioning in euthymic patients with bipolar disorder

Sexual functioning in bipolar disorder (BD) is dependent on multiple clinical and demographic determinants that can eventually lead to sexual dysfunction. However, the contribution of affective temperaments remains unstudied in this population. In this cross-sectional multicentric work, we studied the impact of temperament traits on sexual functioning in 100 euthymic BD outpatients treated only with mood stabilizers with or without benzodiazepines. Temperament was evaluated using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego - Autoquestionnaire (TEMPS-A) and sexual functioning with the Changes on Sexual Functioning Questionnaire (CSFQ-14). The effect of temperament on sexual functioning was analyzed using Bayesian ordinal regression models, which included age, gender, BD type, dominant polarity, metabolic syndrome, marital status, and affective symptomatology. Our results showed that hyperthymic traits predicted a significantly higher CSFQ-14 score for global sexual functioning (OR = 1.222; 95% CI [1.073, 1.431]), desire (OR = 1.164; 95% CI [1.025, 1.357]), arousal (OR = 1.278; 95% CI: [1.083, 1.551]), and orgasm (OR = 1.182; 95% CI [1.037, 1.365]). We did not find a significant contribution for other types of temperaments. Better sexual functioning was also associated with a better quality of life. Our findings highlight the importance of temperament traits in sexual functioning in euthymic BD, which may have implications in sexual dysfunction prevention.

A Feasibility Study of the Usefulness of the TEMPS-A Scale in Assessing Affective Temperament in Athletes

Background and objectives: Current studies show an important role of affective temperament in sport performance. The aim of this study was to assess the feasibility of the use of the TEMPS-A scale, by using it to examine five dimensions of affective temperament in three groups of athletes. We hypothesized that temperament may be a predisposing factor to the level of commitment and type of training. Materials and methods: The study group (N:71, 33 female) consisted of professional canoeists (N:25, aged 18–30), sports pilots (N:21, aged 19–57) and non-professionals regularly performing aerobic exercises (N:25, aged 23–33). The Affective Temperament of Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) was used to evaluate affective temperament dimensions. Statistical analysis was performed using non-parametric tests. Results: The TEMPS_A scale shows good internal consistency; a hyperthymic temperament was associated with different factors compared to other temperament traits. The most prevalent trait in the study group was hyperthymic temperament. The study group scored higher on hyperthymic and lower on depressive and anxious temperaments when compared with the general population. Canoeists scored higher on cyclothymic temperament compared with non-professional athletes and on cyclothymic and irritable dimensions in comparison with pilots. Pilots obtained significantly lower scores on irritable and anxious temperaments than non-professional athletes. Females scored higher on both hyperthymic and irritable dimensions. No significant differences were found in respect of depressive, cyclothymic and anxious traits. Age was negatively correlated with cyclothymic and irritable temperament scores. Conclusions: TEMPS-A scale is a useful tool for assessing affective temperament in athletes. The results suggest that affective temperament may be a factor influencing physical activity engagement. Different types of activities may be connected with different temperament dimensions. Younger athletes present a higher tendency to mood lability and sensitivity to environmental factors. However, further research is needed, involving larger numbers of subjects.

Affective temperaments of Lebanese patients with schizophrenia: comparison by gender and severity of psychosis

Objectives

Our aim in this study was to identify affective temperament differences utilizing the TEMPS-A in a large sample size of Lebanese patients with schizophrenia and compare them to healthy controls. Gender differences, demographic factors and degree of psychotic symptoms were also considered. A cross‐sectional study was conducted at the Psychiatric Hospital of the Cross (PHC) from March to June 2019. Two-hundred fifty chronic patients with schizophrenia were compared to 250 healthy controls randomly chosen from the general population.

Results

Patients with schizophrenia significantly had higher mean depressive, cyclothymic, irritable and anxious temperament scores compared to healthy controls. Healthy controls significantly had a higher mean hyperthymic temperament score compared to patients with schizophrenia. In the group of patients with schizophrenia exclusively, females scored higher in terms of depressive, cyclothymic and anxious temperaments compared to males. In the group of healthy controls, males scored higher in terms of hyperthymic and irritable temperaments compared to females, whereas a higher mean depressive and anxious temperament scores were significantly found in females compared to males. In addition, higher PANSS total scores, as well as higher positive, negative and general subscales scores were significantly associated with higher depressive, cyclothymic, irritable and anxious temperament scores.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-021-05854-8.

Affective lability as a prospective predictor of subsequent bipolar disorder diagnosis: a systematic review

Objectives

The early pathogenesis and precursors of Bipolar Disorder (BD) are poorly understood. There is some cross-sectional and retrospective evidence of affective lability as a predictor of BD, but this is subject to recall biases. The present review synthesises the prospective evidence examining affective lability and the subsequent development of BD at follow-up.

Methods

The authors performed a systematic search of PubMed, PsycInfo and Embase (1960–June 2020) and conducted hand searches to identify studies assessing affective lability (according to a conceptually-inclusive definition) at baseline assessment in individuals without a BD diagnosis, and a longitudinal follow-up assessment of bipolar (spectrum) disorders. Results are reported according to the PRISMA guidelines, and the synthesis without meta-analysis (SWiM) reporting guidelines were used to strengthen the narrative synthesis. The Newcastle–Ottawa Scale was used to assess risk of bias (ROB).

Results

11 articles describing 10 studies were included. Being identified as having affective lability at baseline was associated with an increased rate of bipolar diagnoses at follow-up; this association was statistically significant in six of eight studies assessing BD type I/II at follow-up and in all four studies assessing for bipolar spectrum disorder (BSD) criteria. Most studies received a ‘fair’ or ‘poor’ ROB grade.

Conclusions

Despite a paucity of studies, an overall association between prospectively-identified affective lability and a later diagnosis of BD or BSD is apparent with relative consistency between studies. This association and further longitudinal studies could inform future clinical screening of those who may be at risk of BD, with the potential to improve diagnostic accuracy and facilitate early intervention.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40345-021-00237-1.

Predictive factors of quality of life in temporal and extratemporal lobe epilepsy: association with affective temperament profiles and psychiatric comorbidities

BACKGROUND

Investigating predictive factors of reduced quality of life (QOL) of patients and their association with focal epilepsy can improve management and treatment strategies.

OBJECTIVE

This study aimed to investigate the relationship between affective temperaments, depression, anxiety, disease characteristics, and QOL and to explore the predictors of QOL in patients with temporal lobe epilepsy (TLE) and extratemporal lobe epilepsy (ETLE).

METHODS

A total of 50 patients with TLE, 51 patients with ETLE, and 70 controls were enrolled. Affective temperaments were evaluated using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A). QOL was assessed by the Short-Form Health Survey (SF-36). Beck Depression Inventory and Beck Anxiety Inventory were used to explore depression and anxiety severity, respectively.

RESULTS

Compared with the controls, patients with TLE and ETLE had significantly higher scores on all TEMPS-A scales, except on hyperthymic temperament. All the SF-36 subscale scores were lower in the TLE and ETLE groups. Linear regression analysis revealed that depressive symptoms, anxiety, depressive and irritable temperament, and seizure frequency were significant predictors of QOL in TLE. Patients with ETLE with temperamental disturbances, depressive symptoms, and polytherapy had a poorer QOL.

CONCLUSIONS

Affective temperaments, psychiatric disorders, and clinical factors may predict impaired QOL in patients with TLE and ETLE. Further studies are needed to identify predictors of QOL in various epilepsy subtypes.

Affective temperaments and depressive symptoms: The mediating role of attachment

BACKGROUND

Studies showed that affective temperaments and attachment are associated with depressive symptoms, and that they bi-directionally influence each-other. The aim of this study is to explore mechanisms underlying the relationship between the affective temperaments (i.e., depressive, cyclothymic, irritable, hyperthymic and anxious), interview-based attachment, and depressive symptoms.

METHODS

A sample of 61 adolescents and young adults outpatients were asked to complete the Temperament Evaluation of Memphis, Pisa, and San Diego Autoquestionnaire (TEMPS-A) and the Hamilton Rating Scale for Depression (HAM-D). Attachment was assessed through the Adult Attachment Interview (AAI) and employing a dimensional approach to obtain continuous measures. Mediation models were performed with the affective temperaments as predictor, depressive symptoms as the criterion variable, and attachment dimensions as mediators.

RESULTS

Findings showed significant direct effects between all the affective temperaments and depressive symptoms. Only the cyclothymic (β = 0.22; SE = 0.1; 95% IC = 0.05, 0.42) and irritable (β = 0.21; SE = 0.09; 95% IC = 0.04, 0.4) temperaments showed an indirect effect on depressive symptoms through secure-insecure attachment. Dismissing attachment did not predict either the affective temperaments nor depressive symptoms. Preoccupied attachment significantly predicts depressive symptoms and, when controlling for it, the hyperthymic temperament no longer directly associates with depressive symptoms.

LIMITATIONS

The cross-sectional study design limit conclusion about causation and directionality.

CONCLUSIONS

Secure attachment could be a protective factor for depressive symptoms for individuals with a cyclothymic or irritable temperament. Differently, the hyperthymic temperament loses its protective role toward depressive symptoms when accounting for preoccupied attachment.

Validation study of the Spanish brief version of TEMPS-A

INTRODUCTION

Identifying affective temperaments could be useful both for understanding the normal behavioral variations in the general population and to establish if there is a clinical predisposition to certain disorders. Five affective temperaments have been proposed: depressive, cyclothymic, hyperthymic, irritable and anxious. Original instrument for measuring them (TEMPS-A) is a 110-item scale but many short versions in different languages have been validated. The aim of this study was to obtain a short self-administered Spanish version of TEMPS-A with good psychometric properties.

MATERIALS AND METHODS

A sample of 550 students who answered the argentinean version of TEMPS-A was included, after psychometric analysis a comparison between inpatients with major depression and their matched controls by sex and age who answered the brief version was performed to get an external validation.

RESULTS

The sample was composed by 298 (54.2%) women. The mean age was 23.3 year (SD=6.2). A forced five factor analysis was performed. The 7 items with the highest factorial load (more than 0.350) for each subscale were included in the brief version. The Cronbach alpha's ranged from 0.690 to .800. The most prevalent temperament was hyperthymic followed by cyclothymic for students sample. Similarities between students and controls sample were observed, but not with patients with major depression.

CONCLUSIONS

This brief Spanish version of TEMPS-A (35 items) has good psychometric properties and can be used in general and clinical population.

Emotional Dysregulation, Temperament and Lifetime Suicidal Ideation among Youths with Mood Disorders

Background: Psychopathological dimensions contributing to suicidal ideation in young age are poorly understood. We aimed to investigate the involvement of emotional dysregulation and temperament in suicide risk in a sample of accurately selected young patients with mood disorders and a matched sample of healthy controls (HC). Methods: We assessed 50 young patients (aged 14–25 years) with DSM-5 bipolar or depressive disorders for clinical and psychopathological characteristics and 82 age and sex, educational level, and smoking habits-matched HC. Emotional dysregulation and temperament were assessed using the Difficulties in Emotion Regulation Scale (DERS) and the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire (TEMPS-A-39), respectively. We tested their associations with suicidal ideation, using standard univariate/bivariate methods, preceded by overall multivariate analysis. Results: In the group of patients, 24 (48%) reported lifetime suicide ideation (LSI). Patients with LSI scored higher on emotional dysregulation (p < 0.001) and cyclothymic (p < 0.001), irritable (p = 0.01), and hyperthymic temperaments (p = 0.003) than HC. Patients with LSI specifically presented with more emotional dysregulation (p < 0.001) and cyclothymic temperament (p = 0.001), than patients without LSI (N = 26). Conclusions: Temperamental features, in particular cyclothymic temperament, and emotion dysregulation may represent independent factors for increased vulnerability to lifetime suicidal ideation in young adults with mood disorders.

Development and Validation of the Mood Instability Questionnaire-Trait (MIQ-T)

Background and objectives: Mood instability (MI) is a stable trait associated with psychiatric disorders, yet there is a lack of tools to measure MI. The purpose of this study was to develop and validate the Mood Instability Questionnaire-Trait (MIQ-T) to evaluate MI in mood disorder patients. Material and methods: Items were taken from various established questionnaires to create an initial list of MIQ-T questions. Data from 309 psychiatric patients (n = 309; 62 major depressive disorder, 58 bipolar I disorder, and 189 bipolar II disorder) were gathered from their medical records and were utilized in an exploratory factor analysis to clarify the underlying components of MI. Then, anonymous survey data from 288 individuals from the general population were included in the analysis as a comparison group. Associations between MIQ-T and other previously validated clinical instruments for mood disorders were examined to test external validity. Results: The exploratory factor analysis demonstrated that the five-factor structure (Lability, Upward Tendency, Downward Tendency, Childhood Instability, and Seasonality) of 59 items was the most appropriate with clear, cohesive features. MIQ-T exhibited high internal consistency (α = 0.96) and moderate to strong correlations with other previously validated clinical instruments, which were consistent with theoretical predictions, providing evidence of criterion validity. Short forms were also created to address the high internal consistency value, which can indicate redundancy, and to increase the approachability of the measure. We found that the patients with bipolar II disorder had higher MIQ-T scores than the patients with bipolar I disorder or major depressive disorder and the comparison group. Conclusion: Together, these findings validate the newly developed MIQ-T as an instrument of mood instability. MIQ-T can be a potential research tool for mood disorder.

Anxious temperament and cyberchondria as mediated by fear of COVID-19 infection: A cross-sectional study

This study's main goal was to evaluate the association between anxious temperament and the fear of COVID-19-related self-infection and infection in loved ones (family members, friends, relatives) and cyberchondria. The sample consisted of 499 men and women aged between 18 and 72 who were gathered from the general population via an online recruitment platform. A numerical rating scale comprising 11 degrees of fear was used to assess participants' COVID-19-related fear, and affective temperaments were evaluated using Akiskal's Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) scales. Cyberchondria was assessed using McElroy and Shevlin's Cyberchondria Severity Scale (CSS). Small to medium positive correlations were found between depressive, cyclothymic, irritable and anxious temperaments and cyberchondria and between depressive and anxious temperaments and COVID-19 fears. However, no correlation was observed between the hyperthymic temperament and cyberchondria. Cyberchondria positively correlated with both COVID-19 fears scales, though the correlation coefficients were medium. Based on the results of linear regression analysis, only anxious temperament and COVID-19 fear of self-infection were significant predictors of cyberchondria. The analysis also revealed a significant indirect effect of anxious temperament on cyberchondria through fear of COVID-19 self-infection as a mediator between anxious temperament and cyberchondria.

Influence of Psychological Vulnerability Factors for Bipolar Disorders on a Semantic Mediated Priming Task

Hypomanic personality, hyperthymic temperament and irritable temperament are considered as psychological vulnerability factors to bipolar disorders. Semantic memory is impaired in bipolar patients. Spreading activation is among the probable candidates for accounting this impairment. The aim of this study was to assess spreading activation according to vulnerability factors continuum to determine whether it could be a factor of vulnerability to bipolar disorders. A sample of 61 healthy volunteers was recruited. Spreading activation was assessed by semantic mediated priming implemented in a double lexical decision task. Results shown that semantic mediated priming was negatively associated to hyperthymic temperament and irritable temperament. Impairment in semantic memory, and more specifically spreading activation, appear to be a cognitive factor of vulnerability to bipolar disorders. Our results can contribute to a better understanding of semantic impairment in vulnerable population and in bipolar disorder.

The association between accelerated vascular aging and cyclothymic affective temperament in women

OBJECTIVE

Affective temperaments (depressive, anxious, irritable, hyperthymic, cyclothymic) are regarded as the biologically stable core of personality. Accumulating data suggest their relationship with cardiovascular diseases. However, there are currently limited data on the association of affective temperaments and accelerated vascular aging. The aim of our study was to evaluate the relationship between affective temperaments and vascular age, as assessed by coronary artery calcium scoring (CACS).

METHODS

In our cross-sectional study, 209 consecutive patients referred to coronary computed tomography angiography (CCTA) due to suspected coronary artery disease (CAD) were included. All patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) and the Beck Depression Inventory (BDI). Vascular age was estimated using CACS and its difference from chronological age for each patient was calculated. Linear regression analysis was used to identify predictors of accelerated vascular aging in the entire cohort and in male and female sub-populations.

RESULTS

Besides traditional risk factors, cyclothymic temperament score proved to be an independent predictor of accelerated vascular aging in women (β = 0.89 [95%CI: 0.04-1.75]), while this association was absent in men.

CONCLUSIONS

Our results suggest that cyclothymic affective temperament is associated with accelerated vascular aging in women. Assessment of affective temperaments may potentiate more precise cardiovascular risk stratification of patients.

Phubbing and temperaments among young Lebanese adults: the mediating effect of self-esteem and emotional intelligence

Background

The rapid increasing rate of mobile and internet users in Lebanon, predisposes us to a high dependency on smartphones, leading to more phubbing. Phubbing has been found associated with many psychological factors. Thus, the main objectives of this study was (1) to evaluate the association between phubbing and temperaments, and (2) assess the mediating effect of self-esteem and emotional intelligence in the association between phubbing and temperaments among a sample of Lebanese adults.

Methods

A cross-sectional study, carried out between August and September 2020, enrolled 461 participants aged between 18 and 29 years old. Participants were recruited from all districts/governorates of Lebanon (Beirut, Mount Lebanon, North Lebanon, South Lebanon, and Bekaa) using the snowball technique. The Generic Scale of Phubbing, Rosenberg Self‐Esteem Scale, Schutte Self Report Emotional Intelligence Test and TEMPS-M were used to assess phubbing, self-esteem, emotional intelligence and temperaments respectively.

Results

Our results showed that higher depressive temperament (B = 1.21) was significantly associated with more phubbing, whereas higher self-esteem (B = − 0.32) was significantly associated with less phubbing. Regarding the mediating effect, self-esteem partially mediated the association between depressive temperament and phubbing (21.02%), whereas emotional intelligence had no mediating effect on the association between temperaments and phubbing.

Conclusion

A strong correlation between phubbing and temperaments has been found in our study with a partial mediating effect of self-esteem in this association. Our findings might be a first step for raising awareness to develop the etiquette of using smartphones by providing media education to families, and good media usage habits.

Evaluation of affective temperament profile and levels of depressive symptoms and anxiety in patients with restless legs syndrome

PURPOSE

Restless legs syndrome (RLS) is a sleep-related sensorimotor disorder associated with mood and anxiety disorders. Although affective temperaments are considered subclinical manifestations of mood disorders (MDs), to date, no previous research has explored the relationship between affective temperaments and RLS. We aimed to evaluate affective temperaments, depressive symptoms, and anxiety among newly diagnosed, drug-naive patients with RLS. Additionally, our study identified possible associations between clinical variables and affective temperaments, depressive symptoms, and anxiety profiles in this group.

METHODS

The study included 74 patients with RLS and 90 healthy volunteers. All participants performed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire, Beck Depression Inventory, and Hamilton Anxiety Inventory.

RESULTS

Temperament, depression, and anxiety scores in patients with RLS were significantly higher than those in healthy controls (p ≤ 0.05). Linear regression analysis showed that anxious temperament scores were positively related to longer disease duration (β = 0.658, p = 0.000), whereas disease severity (as measured by the International RLS Study Group Rating Scale) (β = 0.447, p = 0.006) and lower educational status (β =  - 0.803, p = 0.008) correlated with the anxiety profile.

CONCLUSIONS

Results suggested that higher scores on the affective temperament, depression, and anxiety scales indicate subclinical MDs and psychiatric comorbidities in RLS. Therefore, exploring the predictors of mood and anxiety disorders in patients with RLS may improve treatment strategies and clinical outcomes.

Covariation between spontaneous neural activity in the insula and affective temperaments is related to sleep disturbance in individuals with major depressive disorder

BACKGROUND

Affective temperaments have been considered antecedents of major depressive disorder (MDD). However, little is known about how the covariation between alterations in brain activity and distinct affective temperaments work collaboratively to contribute to MDD. Here, we focus on the insular cortex, a critical hub for the integration of subjective feelings, emotions, and motivations, to examine the neural correlates of affective temperaments and their relationship to depressive symptom dimensions.

METHODS

Twenty-nine medication-free patients with MDD and 58 healthy controls underwent magnetic resonance imaging scanning and completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS). Patients also received assessments of the Hamilton Depression Rating Scale (HDRS). We used multivariate analyses of partial least squares regression and partial correlation analyses to explore the associations among the insular activity, affective temperaments, and depressive symptom dimensions.

RESULTS

A profile (linear combination) of increased fractional amplitude of low-frequency fluctuations (fALFF) of the anterior insular subregions (left dorsal agranular-dysgranular insula and right ventral agranuar insula) was positively associated with an affective-temperament (depressive, irritable, anxious, and less hyperthymic) profile. The covariation between the insula-fALFF profile and the affective-temperament profile was significantly correlated with the sleep disturbance dimension (especially the middle and late insomnia scores) in the medication-free MDD patients.

CONCLUSIONS

The resting-state spontaneous activity of the anterior insula and affective temperaments collaboratively contribute to sleep disturbances in medication-free MDD patients. The approach used in this study provides a practical way to explore the relationship of multivariate measures in investigating the etiology of mental disorders.

Resilience and mental health during the COVID-19 pandemic

BACKGROUND

Resilience is a process that allows recovery from or adaptation to adversities. The aim of this study was to evaluate state resilience during the COVID-19 pandemic in psychiatric patients (PP), unaffected relatives (UR) and community controls (CC).

METHODS

This study is part of the Barcelona ResIlience Survey for Mental Health COVID-19 (BRIS-MHC) project. Logistic regression models were performed to identify mental health outcomes associated with bad state resilience and predictors of good state resilience. The association between state resilience and specific affective temperaments as well as their influence on the association between depressive symptoms and state resilience were verified.

RESULTS

The study recruited 898 participants that took part in the survey. The presence of depressive symptoms was a predictor of bad state resilience in PP (β=0.110, OR=1.117, p=0.028). No specific mental health outcome was associated with bad state resilience in UR and CC. Predictors of good state resilience in PP were having pursued hobbies/conducted home tasks (β=1.261, OR=3.528, p=0.044) and level of organization in the family (β=0.986, OR=2.682, p=0.008). Having a controlling family was inversely associated with good state resilience in CC (β=-1.004, OR=0.367, p=0.012). The association between bad state resilience and depressive symptoms was partially mediated by affective temperaments.

LIMITATIONS

Participants self-reported their psychiatric diagnoses, their relatives' diagnoses or the absence of a psychiatric disorder, as well as their psychiatric symptoms.

CONCLUSIONS

Enhancing resilience and coping strategies in the face of the COVID-19 pandemic might have important implications in terms of mental health outcomes.

Cortical myelin content mediates differences in affective temperaments

BACKGROUND

Affective temperaments are regarded as subclinical forms and precursors of mental disorders. It may serve as candidates to facilitate the diagnosis and prediction of mental disorders. Cortical myelination likely characterizes the neurodevelopment and the evolution of cognitive functions and reflects brain functional demand. However, little is known about the relationship between affective temperaments and myelin plasticity. This study aims to analyze the association between the affective temperaments and cortical myelin content (CMC) in human brain.

METHODS

We measured affective temperaments using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) on 106 healthy adults and used the ratio of T1- and T2-weighted images as the proxy for CMC. Using the unsupervised k-means clustering algorithm, we classified the cortical gray matter into heavily, intermediately, and lightly myelinated regions. The correlation between affective temperaments and CMC was calculated separately for different myelinated regions.

RESULTS

Hyperthymic temperament correlated negatively with CMC in the heavily myelinated (right postcentral gyrus and bilateral precentral gyrus) and lightly myelinated (bilateral frontal and lateral temporal) regions. Cyclothymic temperament showed a downward parabola-like correlation with CMC across the heavily, intermediately, and lightly myel0inated areas of the bilateral parietal-temporal regions.

LIMITATIONS

The analysis was constrained to cortical regions. The results were obtained from healthy subjects and we did not acquired data from patients of affective disorder, which may compromise the generalizability of the present findings.

CONCLUSION

The findings suggest that hyperthymic and cyclothymic temperaments have a CMC basis in extensive brain regions.

Effects of the COVID-19 pandemic and lockdown in Spain: comparison between community controls and patients with a psychiatric disorder. Preliminary results from the BRIS-MHC STUDY

BACKGROUND

The aim of this study was to evaluate potential differences about the effects of the COVID-19 pandemic and lockdown between community controls (CC) and patients with a mental illness (MI) in a Spanish population during the state of emergency.

METHODS

Individuals with a psychiatric condition and the general population were invited to complete an anonymous online survey. Bivariate analyses were used to compare them in a broad range of measures: sociodemographic, clinical variables, behavioral changes related to the lockdown and coping strategies to face it. Two groups of different psychiatric disorders were compared: depression or anxiety disorders (D+A) versus bipolar disorder and schizophrenia related disorders (BD+SCZ).

RESULTS

413 CC and 206 MI were included in the study. CC reported to use more adaptive coping strategies as following a routine, talking to friends/relatives, practicing physical exercise and maintaining a balanced diet. MI reported significantly more anxiety and depression symptoms during the lockdown when compared to CC. Gaining weight, sleep changes, and tobacco consumption were more prevalent in the MI group. The D+A group showed significantly more psychological distress and negative expectations about the future, suffered more sleep disturbances when compared to BD+SCZ, whilst reported to practice more exercise.

LIMITATIONS

psychiatric disorders were self-reported.

CONCLUSIONS

Imposed restrictions and uncertainty during confinement had a higher psychological impact in individuals with a psychiatric illness, with less healthy behavior strategies to face the situation. Developing interventions to mitigate negative mental health outcomes among this vulnerable population will be essential in the coming months.

Presence and Overlap of Bipolar Symptoms and Borderline Features during Major Depressive Episodes

BACKGROUND

Bipolar symptoms and borderline personality features occur in both unipolar and bipolar major depressive episodes (MDEs). We investigated their prevalence, severity, co-occurrence and overlap.

METHODS

We interviewed 124 psychiatric outpatients with MDE using the Structured Clinical Interview for DSM-IV-TR Axis I and II Disorders, the Borderline Personality Disorder Severity Index (BPDSI-IV), and about past (hypo)manic episodes, and stratified them according to the principal diagnosis into subcohorts of major depressive disorder (MDD, n = 50), bipolar disorder (BD, n = 43), and borderline personality disorder (BPD, n = 31). We quantified (hypo)manic symptoms using a novel semi-structured interview (MIXed symptoms during MDE, MIX-MDE) with good psychometric qualities.

RESULTS

The subcohorts did not differ in MDE severity. They differed significantly in some (hypo)manic symptoms being present on most days in 24% of MDD, 30% of BD, and 42% of BPD subcohort, but only 5% of the BD subcohort fulfilled the DSM-5 mixed features. The mean MIX-MDE scores were 5.7 (SD 4.0), 12.0 (8.2) and 10.5 (7.5), and BPDSI-IV scores 15.6 (7.0), 17.2 (6.2) and 26.9 (8.7), respectively (both p < 0.001). (Hypo)manic days and unspecific symptoms of distractibility and irritability inflated the correlation of observed (hypo)manic symptoms and borderline features.

LIMITATIONS

Moderate sample size, limited age variation (18-50 years); no previous validation of MIX-MDE.

CONCLUSIONS

Presence of some mixed and borderline features is common in MDEs, with overlap and diagnosis-specific differences. Unspecific symptoms of irritability and distractibility and the aggravating impact of hypomania on perceived BPD features blur the differential diagnosis.

The relation of major depression, OCD, personality disorders and affective temperaments with Temporal lobe epilepsy

BACKGROUND

In patients with temporal lobe epilepsy (TLE), studies demonstrate frequent comorbidity with mood disorders, personality disorders (especially obsessive-compulsive disorder) and major depression, but there are conflicting findings. This study aimed to investigate psychiatric comorbidities and affective temperament among TLE patients and to explore the relationships between obsessive compulsive disorder, other personality disorders, major depression and affective temperament in order to clarify the mediator effect of TLE in these relationships.

METHODS

Thirty patients with TLE and 30 healthy volunteers were included. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Structured Clinical Interview for DSM III-R Axis II Disorders (SCID-II), Hamilton Anxiety (HAM-A) scale, Hamilton Depression (HAM-D) scale, Beck Suicidal Ideation Scale (BSSI) and Yale Brown Obsession Compulsion Scale (YBOCS) were applied and evaluated by a psychiatrist. Additionally, all individuals completed The Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A).

RESULTS

Patients with temporal lobe epilepsy had higher scores in TEMPS-A, HAM-A, HAM-D, YBOCS and BSSI. Major depression, obsessive compulsive disorder and dependent and antisocial personality disorders were prevalent in patients. With respect to affective temperaments, depressive, cyclothymic and anxious temperaments were associated with obsessive compulsive disorder comorbidity; whereas, depressive and anxious temperaments were found to be associated with major depression comorbidity in patients with TLE. Furthermore, cluster A and cluster C personality disorders were associated with affective temperaments in patients with TLE. Affective temperaments had no correlation with illness duration, seizure frequency, depression severity and suicidal thoughts, but obsessions and compulsions. Suicidal thoughts were associated with obsessions and compulsions.

CONCLUSION

Affective temperaments are core personality traits with biological background and they may provide a foundation for psychiatric disorders, especially mood disorders. Considering that TLE originates from abnormalities in brain circuitry, it may form a basis for psychiatric disorders. Therefore, psychiatric evaluation to determine comorbidities may be beneficial to increase the quality of life of patients with TLE.

Bipolar disorder: An evolutionary psychoneuroimmunological approach

Bipolar disorder is a mental health disorder characterized by extreme shifts in mood, high suicide rate, sleep problems, and dysfunction of psychological traits like self-esteem (feeling inferior when depressed and superior when manic). Bipolar disorder is rare among populations that have not adopted contemporary Western lifestyles, which supports the hypothesis that bipolar disorder results from a mismatch between Homo sapiens's evolutionary and current environments. Recent studies have connected bipolar disorder with low-grade inflammation, the malfunctioning of the internal clock, and the resulting sleep disturbances. Stress is often a triggering factor for mania and sleep problems, but stress also causes low-grade inflammation. Since inflammation desynchronizes the internal clock, chronic stress and inflammation are the primary biological mechanisms behind bipolar disorder. Chronic stress and inflammation are driven by contemporary Western lifestyles, including stressful social environments, unhealthy dietary patterns, limited physical activity, and obesity. The treatment of bipolar disorder should focus on reducing stress, stress sensitivity, and inflammation by lifestyle changes rather than just temporarily alleviating symptoms with psychopharmacological interventions.

Affective Temperament is Associated with Stress Coping Strategies and Work Stress Perception Among Polish Bank Employees

Background

Stress in the banking workplace is associated with psychological and health problems. Intensity of work-related stress experiences is associated with specificity of job stress factors personal features such as affective temperament. The aim of the study was to evaluate associations between affective temperament, coping stress strategies, and perceived job stress in bank employees.

Methods

Subjects were 209 bank workers aged 22–55 years (n = 101 managers and 108 non-managers). Affective temperament and stress coping strategies were evaluated using the Temperament Evaluation of Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) and Coping Inventory for Stressful Situations (CISS), respectively. Both questionnaires, TEMPS-A and CISS, show good internal consistency and are proper research methods in the bank employee group. Perceived job-related stress was rated for different sources of job stress common among bank workers.

Results

Depressive temperament was negatively associated with coping style focused on avoidance, and with job stress regarding “responsibility for decisions regarding other people” and “frequent trips.” Irritable temperament was positively correlated with coping style focused on task and job stress regarding “frequent trips.” Cyclothymic temperament was positively correlated with job stress regarding “direct work with money” and “organizational conditions of work.” Multidimensional linear regression showed that irritable and anxious temperaments were associated with coping style focused on task; depressive temperament was associated with coping style focused on avoidance; and cyclothymic temperament was associated with intensity of job stress. The results obtained indicate different levels of job-related stress associated with different sources in bank employees, working with managers and non-managers positions. Affective temperament was associated with stress coping strategies and intensity of perceived job stress. On the basis of affective temperament dimensions it is possible to predict stress coping styles and work-related stress perception in bank employees.

Conclusion

Affective temperament traits measured by TEMPS-A were associated with stress coping strategies and intensity of work stress perception in Polish bank employees.

Effects of Temperamental Characteristics on Depression-Anxiety Levels and the Quality of Life in Infertile Women

Objective

It is known that the risk of anxiety disorders and depression in infertile women increases and their quality of life deteriorates. Temperamental characteristics are considered as predictors of mood disorders. The aim of this study was to investigate temperamental characteristics in infertile women and their effects on depression and anxiety levels, and the quality of life, and to reveal the differences and level of relationship compared to healthy women.

Method

Fourty-four female patients with primary infertility and 30 healthy female controls were included in this study. Temperamental characteristics of the participants were assessed with Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire version (TEMPS-A). Depression and anxiety severity were evaluated with Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). To evaluate the quality of life, Short Form 36 (SF-36) health survey questionnaire was also applied.

Results

Hyperthymic temperament scores were higher in infertile women than the control group (p=0.001). BDI scores were positively correlated with depressive and cyclothymic temperament scores, and BAI scores were positively correlated with depressive and anxious temperament scores. A negative correlation was found between hyperthymic temperament and BAI and BDI scores. Hyperthymic temperament scores were positively correlated with both physical and mental subdimension scores of the quality of life scale.

Conclusion

In this study, hyperthymic temperament in infertile women was shown to be protective against anxiety and depression and it also improves the quality of life. Additional studies are needed to clarify the relationship between hyperthymic temperament and ovarian hormones or other biological parameters.