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Li W, Zhou H, Thygesen JH, Heydtmann M, Smith I, Degenhardt F, Nöthen M, Morgan MY, Kranzler HR, Gelernter J, Bass N, McQuillin A. Genome-wide association study of antisocial personality disorder diagnostic criteria provides evidence for shared risk factors across disorders. Psychiatr Genet 2023; 33:233-242. [PMID: 37756443 PMCID: PMC10635348 DOI: 10.1097/ypg.0000000000000352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 06/19/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION While progress has been made in determining the genetic basis of antisocial behaviour, little progress has been made for antisocial personality disorder (ASPD), a condition that often co-occurs with other psychiatric conditions including substance use disorders, attention deficit hyperactivity disorder (ADHD), and anxiety disorders. This study aims to improve the understanding of the genetic risk for ASPD and its relationship with other disorders and traits. METHODS We conducted a genome-wide association study (GWAS) of the number of ASPD diagnostic criteria data from 3217 alcohol-dependent participants recruited in the UK (UCL, N = 644) and the USA (Yale-Penn, N = 2573). RESULTS We identified rs9806493, a chromosome 15 variant, that showed a genome-wide significant association ( Z -score = -5.501, P = 3.77 × 10 -8 ) with ASPD criteria. rs9806493 is an eQTL for SLCO3A1 (Solute Carrier Organic Anion Transporter Family Member 3A1), a ubiquitously expressed gene with strong expression in brain regions that include the anterior cingulate and frontal cortices. Polygenic risk score analysis identified positive correlations between ASPD and smoking, ADHD, depression traits, and posttraumatic stress disorder. Negative correlations were observed between ASPD PRS and alcohol intake frequency, reproductive traits, and level of educational attainment. CONCLUSION This study provides evidence for an association between ASPD risk and SLCO3A1 and provides insight into the genetic architecture and pleiotropic associations of ASPD.
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Affiliation(s)
- Wenqianglong Li
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Hang Zhou
- Department of Psychiatry, Yale School of Medicine, New Haven
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Johan H. Thygesen
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
- Institute of Health Informatics, University College London, London, UK
| | - Mathis Heydtmann
- Royal Alexandria Hospital, NHS Greater Glasgow and Clyde, Paisley, UK
- Department of Gastroenterology, Dumfries & Galloway Royal Infirmary, Cargenbridge, Dumfries, Scotland
| | - Iain Smith
- Substance misuse service, Mayfield Centre, St Ninians, Stirling, UK
| | - Franziska Degenhardt
- Department of Child and Adolescent Psychiatry, University of Duisburg-Essen, Essen
| | - Markus Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Marsha Y. Morgan
- UCL Institute for Liver & Digestive Health, Division of Medicine, Royal Free Campus, University College London, London, UK
| | - Henry R. Kranzler
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine
- Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania
| | - Joel Gelernter
- Department of Psychiatry, Yale School of Medicine, New Haven
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
- Departments of Genetics and Neuroscience, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Nicholas Bass
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Andrew McQuillin
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
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Shura RD, Richard KW, Martindale SL, Brearly TW, Taber KH, Canu WH. Internalizing and externalizing comorbidity and symptom burden in a VA ADHD specialty evaluation clinic. Psychiatry Res 2022; 309:114395. [PMID: 35051878 DOI: 10.1016/j.psychres.2022.114395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to evaluate psychiatric diagnosis and symptom comorbidity in veterans diagnosed with attention-deficit/hyperactivity disorder (ADHD). Study design was retrospective chart review from an ADHD evaluation clinic at a Veterans Affairs hospital. Participants were 227 military veterans who completed a standardized ADHD assessment and produced valid Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) profiles. There were no differences in rates of internalizing or externalizing psychiatric conditions diagnosed in inattentive compared to combined ADHD presentations. However, compared to a subsample with no psychiatric diagnoses, individuals diagnosed with ADHD endorsed significantly more internalizing symptom burden, with combined ADHD veterans also endorsing significantly greater levels of negative emotions and neuroticism. Base rates of comorbid classes of psychiatric diagnoses were not increased in individuals with ADHD, though higher rates of trauma disorders were seen in the combined group compared to the inattentive group. Multivariate base rates of MMPI-2-RF Restructured Clinical scales across various subgroups are presented. There was evidence for differential phenotypes of psychiatric symptoms across ADHD presentations in clinically referred veterans, predominantly related to higher rates of internalizing symptoms.
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Affiliation(s)
- Robert D Shura
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center, USA; W. G. (Bill) Hefner Veterans Affairs Healthcare System, Salisbury, NC, USA; Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Kevin W Richard
- W. G. (Bill) Hefner Veterans Affairs Healthcare System, Salisbury, NC, USA
| | - Sarah L Martindale
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center, USA; W. G. (Bill) Hefner Veterans Affairs Healthcare System, Salisbury, NC, USA; Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Katherine H Taber
- Mid-Atlantic Mental Illness Research, Education, and Clinical Center, USA; W. G. (Bill) Hefner Veterans Affairs Healthcare System, Salisbury, NC, USA; Via College of Osteopathic Medicine, Blacksburg, VA, USA; Baylor College of Medicine, Houston, TX, USA
| | - Will H Canu
- Appalachian State University, Boone, NC, USA
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Kim S, Lee HK, Lee K. Can the MMPI Predict Adult ADHD? An Approach Using Machine Learning Methods. Diagnostics (Basel) 2021; 11:diagnostics11060976. [PMID: 34071385 PMCID: PMC8229212 DOI: 10.3390/diagnostics11060976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/25/2021] [Accepted: 05/27/2021] [Indexed: 12/24/2022] Open
Abstract
(1) Background: Adult attention-deficit/hyperactivity disorder (ADHD) symptoms cause various social difficulties due to attention deficit and impulsivity. In addition, in contrast to ADHD in childhood, ADHD in adulthood is difficult to diagnose due to mixed psychopathologies. This study aimed to determine whether it is possible to predict ADHD symptoms in adults using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) with machine learning (ML) techniques; (2) Methods: Data collected from 5726 college students were analyzed. The MMPI-2-Restructured Form (MMPI-2-RF) was used, and ADHD symptoms in adults were evaluated using the Attention-Deficit/Hyperactivity Disorder Self-Report Scale (ASRS). For statistical analysis, three ML algorithms were used, i.e., K-nearest neighbors (KNN), linear discriminant analysis (LDA), and random forest, with the ASRS evaluation result as the dependent variable and the 50 MMPI-2-RF scales as predictors; (3) Results: When the KNN, LDA, and random forest techniques were applied, the accuracy was 93.1%, 91.2%, and 93.6%, respectively, and the area under the curve (AUC) was 0.722, 0.806, and 0.790, respectively. The AUC of the LDA method was the largest, with an excellent level of diagnostic accuracy; (4) Conclusions: ML using the MMPI-2 in a large group could provide reliable accuracy in screening for adult ADHD.
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Affiliation(s)
- Sunhae Kim
- Department of Psychiatry, Hanyang University Medical Center, Seoul 04763, Korea;
| | - Hye-Kyung Lee
- Department of Nursing, College of Nursing and Health, Kongju National University, Gongju 32588, Korea;
| | - Kounseok Lee
- Department of Psychiatry, Hanyang University Medical Center, Seoul 04763, Korea;
- Correspondence: ; Tel.: +82-2-2290-8481; Fax: +82-2-2298-2055
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Maternal temperament and character: associations to child behavior at the age of 3 years. Child Adolesc Psychiatry Ment Health 2021; 15:23. [PMID: 33957964 PMCID: PMC8103652 DOI: 10.1186/s13034-021-00375-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/20/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The influence of maternal temperament on child behavior, and whether maternal temperament impact boys and girls differently is not thoroughly studied. The aim was to investigate the impact of maternal temperament and character on child externalizing and internalizing problems at age 3. METHODS A birth-cohort of 1723 mothers and their children were followed from birth to age 3. At the child's age of 3 months, the mothers filled out standardized instruments on their temperament and character using the Temperament and Character Inventory (TCI) and depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS). At the child's age of 3 years, the mothers reported on child behavior using the Child Behaviour Checklist (CBCL). RESULTS Maternal temperamental trait novelty seeking was positively associated with externalizing problems in the total population and in girls. Harm avoidance was positively associated with externalizing problems in the total population and in boys, and with internalizing problems in the total population and boys and girls respectively. Maternal character traits of self-directedness and cooperativeness were negatively associated with both externalizing and internalizing problems in the total population and in boys and girls respectively. CONCLUSIONS Maternal character traits were more influential on child behavior than were temperamental traits, and thus the opportunities for intervention targeted at parental support are good. Maternal mental health and socioeconomic aspects also increased the risk for child behavior problems, indicating the need for recognition and support in clinical settings.
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Nylander E, Floros O, Sparding T, Rydén E, Hansen S, Landén M. Five-year outcomes of ADHD diagnosed in adulthood. Scand J Psychol 2020; 62:13-24. [PMID: 33216369 PMCID: PMC7839718 DOI: 10.1111/sjop.12692] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/21/2020] [Indexed: 11/30/2022]
Abstract
There is a dearth of long‐term follow‐up studies of adults diagnosed with ADHD. Here, the aim was to evaluate long‐term outcomes in a group of ADHD patients diagnosed in adulthood and receiving routine psychiatric health care. Adults diagnosed with any type of ADHD (n = 52) and healthy controls (n = 73) were assessed at baseline and at a 5‐year follow‐up, using Global Assessment of Functioning (GAF), Clinical Global Impression (CGI), Brown ADD Scale (BADDS) and Adult ADHD Self‐Report Scale (ASRS). A multivariate regression method was used to identify factors predicting 5‐year outcomes, including baseline ratings, medication intensity, comorbidity, intelligence quotient (IQ), age, and sex. After 5 years, ADHD patients reported fewer and/or less severe symptoms compared to baseline, but remained at clinically significant symptom levels and with functional deficits. Baseline self‐reports of ADHD symptoms predicted their own 5‐year outcome and low baseline functioning level predicted improved global functioning at follow‐up. Factors previously reported to predict short‐term outcomes (i.e., medication, comorbidity, IQ, age, and sex) did not anticipate long‐term outcomes in present study.
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Affiliation(s)
- Elin Nylander
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Orestis Floros
- ADHD Unit, Sankt Görans Hospital, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Timea Sparding
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Eleonore Rydén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Stefan Hansen
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Medical Epidemiology and Biostatics, Karolinska Institutet, Stockholm, Sweden
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Attention Networks in ADHD Adults after Working Memory Training with a Dual n-Back Task. Brain Sci 2020; 10:brainsci10100715. [PMID: 33050115 PMCID: PMC7600375 DOI: 10.3390/brainsci10100715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/21/2020] [Accepted: 10/05/2020] [Indexed: 01/08/2023] Open
Abstract
Patients affected by Attention-Deficit/Hyperactivity Disorder (ADHD) are characterized by impaired executive functioning and/or attention deficits. Our study aim is to determine whether the outcomes measured by the Attention Network Task (ANT), i.e., the reaction times (RTs) to specific target and cue conditions and alerting, orienting, and conflict (or executive control) effects are affected by cognitive training with a Dual n-back task. We considered three groups of young adult participants: ADHD patients without medication (ADHD), ADHD with medication (MADHD), and age/education-matched controls. Working memory training consisted of a daily practice of 20 blocks of Dual n-back task (approximately 30 min per day) for 20 days within one month. Participants of each group were randomly assigned into two subgroups, the first one with an adaptive mode of difficulty (adaptive training), while the second was blocked at the level 1 during the whole training phase (1-back task, baseline training). Alerting and orienting effects were not modified by working memory training. The dimensional analysis showed that after baseline training, the lesser the severity of the hyperactive-impulsive symptoms, the larger the improvement of reaction times on trials with high executive control/conflict demand (i.e., what is called Conflict Effect), irrespective of the participants’ group. In the categorical analysis, we observed the improvement in such Conflict Effect after the adaptive training in adult ADHD patients irrespective of their medication, but not in controls. The ex-Gaussian analysis of RT and RT variability showed that the improvement in the Conflict Effect correlated with a decrease in the proportion of extreme slow responses. The Dual n-back task in the adaptive mode offers as a promising candidate for a cognitive remediation of adult ADHD patients without pharmaceutical medication.
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Lee JW, Seo K, Bahn GH. The Positive Aspects of Attention-Deficit/Hyperactivity Disorder among Famous People. Psychiatry Investig 2020; 17:424-431. [PMID: 32321205 PMCID: PMC7265029 DOI: 10.30773/pi.2020.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/16/2020] [Accepted: 02/26/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The shortage of clinical data regarding adult patients with often results in adults with ADHD being stigmatized and being inadequately treated. In this paper, famous people who potentially have ADHD were analyzed to understand better, the life-long progression of ADHD. METHODS 131 people were analyzed as potential candidates for ADHD. A grading system for the candidates was developed: class 1, compatible with ADHD; class 2, likely; class 3, less likely; class 4, uncertain with a shortage of data; and class 5, not compatible. Initially, 39 subjects in class 4 and 12 in class 5 were excluded from the analysis. Finally, 80 subjects (30 in class 1, 33 in class 2, and 17 in class 3) were analyzed for sociodemographic data and psychiatric comorbidities. RESULTS 88.8% were men and 47.5% of the subjects were married once. In terms of occupation, 45.0% of the subjects were cultural professionals and 25.0% were chief executives. Narcissistic personality disorder was the most frequently noted comorbidity, followed by substance-related and addictive disorder. CONCLUSION Famous people with ADHD in this study revealed high skill levels in occupation, offering positive aspects of ADHD in adults.
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Affiliation(s)
- Jong Won Lee
- Department of Psychiatry, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Kyunghoon Seo
- Department of Psychiatry, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Geon Ho Bahn
- Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Republic of Korea
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Pinzone V, De Rossi P, Trabucchi G, Lester D, Girardi P, Pompili M. Temperament correlates in adult ADHD: A systematic review ★★. J Affect Disord 2019; 252:394-403. [PMID: 31003108 DOI: 10.1016/j.jad.2019.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 02/11/2019] [Accepted: 04/06/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Attention deficit and hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children, but adult-ADHD is still an under-diagnosed and untreated condition. Treating adult-ADHD is complex and requires effective strategies for ADHD symptoms and comorbidities. Because of its high comorbidity rate with mood disorders and the growing interest in symptoms of emotional dysregulation in these patients, our aim was to collect studies that investigated temperament correlates in adult people with ADHD, to better understand the association between them and the eventual role of temperament as a prognostic-therapeutic marker. METHODS We performed a systematic review of the literature. We included only studies that measured temperament traits in ADHD adults using the Temperament Evaluation of Memphis, Paris and San Diego-Auto-questionnaire (TEMPS-A) or the Temperament and Character Inventory (TCI). RESULTS We retrieved 15 papers that used the TCI and 6 papers that used the TEMPS-A. In the TCI studies, ADHD was associated with high scores on Novelty Seeking and Harm Avoidance and low scores on Persistence. For the TEMPS-A studies, ADHD and Bipolar Disorders share some similarities in temperament scores, except for the hyperthymic temperament score. LIMITATIONS A comparison between the TCI and TEMPS-A results was not possible. The number of papers included was small. Among them, the type of sample, the number of recruited subjects and the ADHD assessment were very different. CONCLUSIONS The majority of ADHD individuals share temperament traits such as lability, irritability and excessiveness of emotional responses. Further research is needed to better understand whether temperament influences the pharmacological response of ADHD patients and whether temperament scores affect the long-term therapeutic outcome.
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Affiliation(s)
- Vito Pinzone
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Pietro De Rossi
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; ASL RM5, Monterotondo, Rome, Italy
| | - Guido Trabucchi
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - David Lester
- Stockton University, Galloway Township, NJ, United States
| | - Paolo Girardi
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
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Updated European Consensus Statement on diagnosis and treatment of adult ADHD. Eur Psychiatry 2018; 56:14-34. [DOI: 10.1016/j.eurpsy.2018.11.001] [Citation(s) in RCA: 201] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/02/2018] [Accepted: 11/03/2018] [Indexed: 12/17/2022] Open
Abstract
AbstractBackground Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness.Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated.Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated?Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.
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Yurumez E, Yazici E, Gumus YY, Yazici AB, Gursoy S. Temperament and Character Traits of Parents of Children With ADHD. J Atten Disord 2018; 22:1200-1206. [PMID: 25515679 DOI: 10.1177/1087054714561292] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study investigates the relationship between ADHD and the personalities of parents of children with ADHD. METHOD Personality traits of parents of children with ADHD (study group; n = 135) and parents of children without ADHD (control group; n = 122) were compared. Psychiatric comorbidities were excluded with Structured Clinical Interview for DSM-IV Axis I Disorders, Clinical Version [SCID-I-CV]. Personality is assessed with Temperament and Character Inventory, and inattention (IA) and hyperactivity (HI) are assessed with Turgay Scale. RESULTS Harm avoidance and persistence scores were higher, and self-directedness (SD) scores were lower in the study group than the control group. Being in ADHD group predicted lower SD scores. Positive correlations were found between harm avoidance and IA and HI, and between persistence and HI. Negative correlations were found between SD and both IA and HI. CONCLUSION Our data suggest that there is relationship between ADHD in children's and parents' personalities. Common etiologic properties and personalized psychoeducation and treatment options for families should be discussed.
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Affiliation(s)
- Esra Yurumez
- 1 Ufuk University, Faculty of Medicine, Child and Adolescent Psychiatry, Ankara, Turkey
| | - Esra Yazici
- 2 Sakarya University, Faculty of Medine, Psychiatry, Sakarya, Turkey
| | | | | | - Salime Gursoy
- 4 Erenkoy Education and Research Hospital, Istanbul, Turkey
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Bilgiç A, Yılmaz S, Özcan Ö, Tufan AE, Özmen S, Öztop D, Akça ÖF, Türkoğlu S, Yar A. The Relationship Between Parental Affective Temperament Traits and Disruptive Behavior Disorders Symptoms in Children With ADHD. J Atten Disord 2018; 22:1235-1245. [PMID: 27125992 DOI: 10.1177/1087054716646449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study investigated the relationship between parental affective temperaments and the oppositional defiant disorder (ODD) and conduct disorder (CD) symptoms of children with ADHD. METHOD The sample consisted of 542 treatment-naive children with ADHD and their biological parents. Children were assessed via both parent- and teacher-rated behavioral disorder scales. Parental affective temperament and ADHD symptoms were measured by self-report inventories. The relationships between psychiatric variables were evaluated using structural equation modeling. RESULTS According to parent-rated behavioral disorder scales, paternal cyclothymic and maternal irritable temperaments were associated with ODD scores, and maternal depressive temperament was associated with CD scores. In terms of teacher-rated behavioral disorder scales, maternal anxious temperament was associated with ODD scores, and paternal cyclothymic and maternal depressive temperaments were associated with CD scores. CONCLUSION These results suggest that certain parental affective temperaments are related to an increase in symptoms of disruptive behavioral disorders in children with ADHD.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ahmet Yar
- 6 Konya Education and Research Hospital, Konya, Turkey
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Ozdemiroglu F, Karakus K, Memis CO, Sevincok L, Mersin S. Temperament in Adulthood Attention Deficit-Hyperactivity Disorder without Bipolar Disorder. Psychiatry Investig 2018; 15:266-271. [PMID: 29475238 PMCID: PMC5900379 DOI: 10.30773/pi.2017.06.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 05/03/2017] [Accepted: 06/07/2017] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE We examined whether some temperamental traits would be associated with persistence of attention deficit-hyperacitivty disorder (ADHD) in adulthood independent from bipolar disorder (BD). METHODS Eighty-one ADHD patients without a comorbid diagnosis of BD were divided into two groups, those with childhood ADHD (n=46), and those with Adulthood ADHD (n=35). The severity of childhood and adulthood ADHD were assessed by using the Wender Utah Rating Scale (WURS-25) and Turgay's Adult ADD/ADHD Diagnosis and Evaluation Scale (DES). Subjects' temperamental characteristics were examined using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire (TEMPS-A). RESULTS The mean scores of WURS-25 were higher in adult ADHD group than in childhood ADHD group (p<0.001). Adult ADHD group had significantly higher scores on cyclothymic (p=0.002), irritable (p<0.0001), and anxious (p=0.042) subscales of TEMPS-A. The scores of WURS-25 in adulthood ADHD group were positively correlated with cyclothymia scores (r=0.366, p=0.033). Total scores of Turgay's Adult ADD/ADHD DES were positively correlated with cyclothymic (r=0.354, p=0.040), hyperthymic (r=0.380, p=0.026), and irritable (r=0.380, p=0.026) subscale scores. Cychlothymic and irritable temperaments were significantly associated with the severity of adulthood symptoms of ADHD. CONCLUSION We might suggest that cyclothymic and irritable temperaments would predict the diagnosis of adulthood ADHD independent from BD.
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Affiliation(s)
| | - Kadir Karakus
- Department of Psychiatry, Adnan Menderes University, Aydın, Turkey
| | | | - Levent Sevincok
- Department of Psychiatry, Adnan Menderes University, Aydın, Turkey
| | - Sanem Mersin
- Karşıyaka State Hospital, Psychiatry Department, Izmir, Turkey
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Kim KM, Nam S, Kim SY, Lee SM, Choi JW, Kang T, Kim JW. Psychopathological, temperamental, and characteristic factors in adults with remaining childhood attention-deficit hyperactivity symptoms. Int J Psychiatry Clin Pract 2017; 21:236-241. [PMID: 28266244 DOI: 10.1080/13651501.2017.1297835] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To investigate differences in psychopathological, temperamental and characteristic factors between young adults with and without persistent Attention-Deficit Hyperactivity disorder (ADHD) symptoms. METHODS A total of 429 university students were divided into three groups: persistent adult ADHD (n = 53), only childhood ADHD (n = 56) and healthy controls (n = 320). The Korean Adult ADHD Scale, Korean Wender-Utah Rating Scale, Beck Depression Inventory-II, Beck Anxiety Inventory, Barratt Impulsiveness Scale, Korean Young Internet Addiction Scale, and Temperament Character Inventory-Revised (TCI-R; based on Cloninger's seven factor model of temperament and character) were used to evaluate psychopathological factors. RESULTS Participants with persistent adult ADHD symptoms had significantly higher levels of childhood ADHD, depression, anxiety and the Internet addiction symptoms than did the only-childhood ADHD and control groups. The adult ADHD group also had significantly higher tendencies toward novelty seeking, harm avoidance, and self-transcendence, as well as low self-directedness and cooperativeness. CONCLUSIONS Results suggest that persistent ADHD is associated with several unfavourable psychopathological, temperamental and characteristic factors. Therefore, thorough evaluation of these factors for childhood ADHD could help predict prognoses and provide treatment plans for preventing persistent ADHD into adulthood.
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Affiliation(s)
- Kyoung Min Kim
- a Division of Child and Adolescent Psychiatry, Department of Psychiatry , Seoul National University College of Medicine , Seoul , Republic of Korea
| | - Sojeong Nam
- a Division of Child and Adolescent Psychiatry, Department of Psychiatry , Seoul National University College of Medicine , Seoul , Republic of Korea
| | - Soo Yeon Kim
- a Division of Child and Adolescent Psychiatry, Department of Psychiatry , Seoul National University College of Medicine , Seoul , Republic of Korea
| | - Soo Min Lee
- a Division of Child and Adolescent Psychiatry, Department of Psychiatry , Seoul National University College of Medicine , Seoul , Republic of Korea
| | - Jae-Won Choi
- a Division of Child and Adolescent Psychiatry, Department of Psychiatry , Seoul National University College of Medicine , Seoul , Republic of Korea
| | - Taewoong Kang
- a Division of Child and Adolescent Psychiatry, Department of Psychiatry , Seoul National University College of Medicine , Seoul , Republic of Korea
| | - Jun Won Kim
- b Department of Psychiatry , Catholic University of Daegu School of Medicine , Daegu , Republic of Korea
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Gomez R, Van Doorn G, Watson S, Gomez A, Stavropoulos V. Cloninger's personality dimensions and ADHD: A meta-analytic review. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.11.054] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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15
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Lee YS, Son JH, Park JH, Kim SM, Kee BS, Han DH. The comparison of temperament and character between patients with internet gaming disorder and those with alcohol dependence. J Ment Health 2017; 26:242-247. [PMID: 28132570 DOI: 10.1080/09638237.2016.1276530] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND The differences in prevalence, natural history, and disease progression between Internet gaming disorder (IGD) and substance use disorder contribute to the controversy over IGD as a diagnosis under substance-related and addictive disorders. AIMS The purpose of the current study was to assess the temperament and character of subjects with IGD in comparison with those with alcohol dependence (AD). METHODS Temperament and character were assessed using Cloningernt temperament and character inventory (TCI). The severity of IGD or AD, depressed mood, anxiety, attention and impulsiveness were assessed using each of the six scales. RESULTS Among patients with AD, after controlling for other variables, the severity of AD was positively correlated with harm avoidance (HA) score and depressed mood. Among patients with IGD, after controlling for other variables, the severity of IGD was positively correlated with novelty seeking (NS) score, impulsiveness and attention. CONCLUSIONS There were significant differences in temperament and character between the IGD and AD groups as measured using the TCI. These results suggest that IGD and AD need to be categorized separately in a diagnostic classification system and benefit from different treatment approaches.
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Affiliation(s)
- Young Sik Lee
- a Department of Psychiatry , Chung-Ang University Hospital , Seoul , Korea
| | - Ji Hyun Son
- a Department of Psychiatry , Chung-Ang University Hospital , Seoul , Korea
| | - Jeong Ha Park
- a Department of Psychiatry , Chung-Ang University Hospital , Seoul , Korea
| | - Sun Mi Kim
- a Department of Psychiatry , Chung-Ang University Hospital , Seoul , Korea
| | - Baik Seok Kee
- a Department of Psychiatry , Chung-Ang University Hospital , Seoul , Korea
| | - Doug Hyun Han
- a Department of Psychiatry , Chung-Ang University Hospital , Seoul , Korea
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16
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Skala K, Riegler A, Erfurth A, Völkl-Kernstock S, Lesch OM, Walter H. The connection of temperament with ADHD occurrence and persistence into adulthood - An investigation in 18 year old males. J Affect Disord 2016; 198:72-7. [PMID: 27011362 DOI: 10.1016/j.jad.2016.03.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 02/22/2016] [Accepted: 03/11/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND This study intended to determine whether certain traits of temperament are associated with former and current ADHD symptomatology in a non-clinical sample of 18 year old males. METHODS We performed a cross sectional descriptive study of 3280 men during the examination for military service. The investigation included a socio-demographic questionnaire, screening for substance abuse, temperament (TEMPS-M), past (WURS) and current (ADHD symptom checklist) ADHD symptomatology. RESULTS We found a correlation of cyclothymic (p<.001), irritable (p<.001) and anxious (p<.05) temperament with occurrence and severity of past and present ADHD symptomatology. No significant correlation has been detected for hyperthymic and depressive temperament. Judged retrospectively, ADHD symptoms were strongly consistent over time. LIMITATIONS The sample consists of men only. These had to be fit enough to be enlisted for military service; men with severe mental or physical disorders were thus excluded. Furthermore, the cross-sectional study design does not allow making conclusions about the temporal relationships between ADHD symptoms and substance misuse. CONCLUSIONS These results indicate that a temperament based approach towards those affected by ADHD might be useful. Subtyping ADHD by integrating temperament profiles in diagnosis and treatment of the disorder could help explain some of the heterogeneity of the disease.
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Affiliation(s)
- K Skala
- University of Vienna, Department of Child and Adolescent Psychiatry, Austria.
| | - A Riegler
- Otto Wagner Spital, Department of Psychiatry IV, Austria
| | - A Erfurth
- Otto Wagner Spital, Department of Psychiatry IV, Austria
| | - S Völkl-Kernstock
- University of Vienna, Department of Child and Adolescent Psychiatry, Austria
| | - O M Lesch
- University of Vienna, Department of Psychiatry, Austria
| | - H Walter
- University of Vienna, Department of Psychiatry, Austria
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17
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Perroud N, Hasler R, Golay N, Zimmermann J, Prada P, Nicastro R, Aubry JM, Ardu S, Herrmann FR, Giannakopoulos P, Baud P. Personality profiles in adults with attention deficit hyperactivity disorder (ADHD). BMC Psychiatry 2016; 16:199. [PMID: 27301261 PMCID: PMC4908674 DOI: 10.1186/s12888-016-0906-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 04/15/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Previous studies suggested that the presence of ADHD in children and young adolescents may affect the development of personality. Whether or not the persistence of ADHD in adult life is associated with distinct personality patterns is still matter for debate. To address this issue, we compared the profiles of the Temperament and Character Inventory (TCI) that assesses personality dimensions in 119 adults ADHD and 403 controls. METHODS ANCOVA were used to examine group differences (controls vs. ADHD and ADHD inattentive type vs. ADHD combined + hyperactive/impulsive types) in Temperaments and Characters. Partial correlation coefficients were used to assess correlation between TCI and expression and severity of symptoms of ADHD. RESULTS High novelty seeking (NS), harm avoidance (HA) and self-transcendence (ST) scores as well as low self-directedness (SD) and cooperativeness (C) scores were associated with ADHD diagnosis. Low SD was the strongest personality trait associated with adult ADHD. Cases with the ADHD inattentive type showed higher HA and lower SD scores compared to the combined and hyperactive/impulsive types. High HA scores correlated with inattention symptoms whereas high NS and ST scores were related to hyperactive symptoms. Finally low SD and high NS were associated with increased ADHD severity. CONCLUSIONS Distinct temperaments were associated with inattentive versus hyperactive/impulsive symptoms supporting the heterogeneous nature of the disorder.
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Affiliation(s)
- Nader Perroud
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland. .,Department of Psychiatry, University of Geneva, Geneva, Switzerland.
| | - Roland Hasler
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland
| | - Nicolas Golay
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland
| | - Julien Zimmermann
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland
| | - Paco Prada
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland
| | - Rosetta Nicastro
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland
| | - Jean-Michel Aubry
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland ,Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Stefano Ardu
- Section of Dental Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Division of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland ,Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Patrick Baud
- Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland
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Matthies S, Philipsen A. Comorbidity of Personality Disorders and Adult Attention Deficit Hyperactivity Disorder (ADHD)--Review of Recent Findings. Curr Psychiatry Rep 2016; 18:33. [PMID: 26893231 DOI: 10.1007/s11920-016-0675-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Children suffering from attention deficit hyperactivity disorder (ADHD) may remit until adulthood. But, more than 60-80% have persisting ADHD symptoms. ADHD as an early manifesting neurodevelopmental disorder is considered a major risk factor for the development of comorbid psychiatric disorders in later life. Particularly, personality disorders are oftentimes observed in adult patients suffering from ADHD. If ADHD and personality disorders share common etiological mechanisms and/or if ADHD as a severely impairing condition influences psychological functioning and learning and leads to unfavorable learning histories is unclear. The development of inflexible and dysfunctional beliefs on the basis of real and perceived impairments or otherness due to the core symptoms of ADHD is intuitively plausible. Such beliefs are a known cause for the development of personality disorders. But, why some personality disorders are more frequently found in ADHD patients as for example antisocial and borderline personality disorder remains subject of debate. Because of the high prevalence of ADHD and the high impact of personality disorders on daily functioning, it is important to take them into account when treating patients with ADHD. Research on the developmental trajectories leading to personality disorders in adult ADHD patients might open the door for targeted interventions to prevent impairing comorbid clinical pictures.
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Affiliation(s)
- Swantje Matthies
- Department of Psychiatry & Psychotherapy, University Medical Centre Freiburg, Hauptstr. 5, D-79104, Freiburg, Germany.
| | - Alexandra Philipsen
- Medical Campus University of Oldenburg, School of Medicine and Health Sciences, D-26111, Oldenburg, Germany. .,Psychiatry and Psychotherapy - University Hospital, Karl-Jaspers-Klinik, Hermann-Ehlers-Straße 7, D-26160, Bad Zwischenahn, Germany.
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