Enhanced creativity in bipolar disorder patients: a controlled study

OBJECTIVE: Associations between eminent creativity and bipolar disorders have been reported, but there are few data relating non-eminent creativity to bipolar disorders in clinical samples. We assessed non-eminent creativity in euthymic bipolar (BP) and unipolar major depressive disorder (MDD) patients, creative discipline controls (CC), and healthy controls (HC). METHODS: 49 BP, 25 MDD, 32 CC, and 47 HC (all euthymic) completed four creativity measures yielding six parameters: the Barron-Welsh Art Scale (BWAS-Total, and two subscales, BWAS-Dislike and BWAS-Like), the Adjective Check List Creative Personality Scale (ACL-CPS), and the Torrance Tests of Creative Thinking--Figural (TTCT-F) and Verbal (TTCT-V) versions. Mean scores on these instruments were compared across groups. RESULTS: BP and CC (but not MDD) compared to HC scored significantly higher on BWAS-Total (45% and 48% higher, respectively) and BWAS-Dislike (90% and 88% higher, respectively), but not on BWAS-Like. CC compared to MDD scored significantly higher (12% higher) on TTCT-F. For all other comparisons, creativity scores did not differ significantly between groups. CONCLUSIONS: We found BP and CC (but not MDD) had similarly enhanced creativity on the BWAS-Total (driven by an increase on the BWAS-Dislike) compared to HC. Further studies are needed to determine the mechanisms of enhanced creativity and how it relates to clinical (e.g. temperament, mood, and medication status) and preclinical (e.g. visual and affective processing substrates) parameters.     

Temperamental commonalities and differences in euthymic mood disorder patients, creative controls, and healthy controls

OBJECTIVE: Understanding of mood disorders can be enhanced through assessment of temperamental traits. We explored temperamental commonalities and differences among euthymic bipolar (BP) and unipolar (MDD) mood disorder patients, creative discipline graduate student controls (CC), and healthy controls (HC). METHODS: Forty-nine BP, 25 MDD, 32 CC, and 47 HC completed self-report temperament/personality measures including: The Affective Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A); the Revised NEO Personality Inventory (NEO-PI-R); and the Temperament and Character Inventory (TCI). RESULTS: Euthymic BP, MDD, and CC, compared to HC, had significantly increased cyclothymia, dysthymia and irritability scores on TEMPS-A; increased neuroticism and decreased conscientiousness on NEO-PI-R; and increased harm avoidance and novelty seeking as well as decreased self-directedness on TCI. TEMPS-A cyclothymia scores were significantly higher in BP than in MDD. NEO-PI-R openness was increased in BP and CC, compared to HC, and in CC compared to MDD. TCI self-transcendence scores in BP were significantly higher than in MDD, CC, and HC. LIMITATIONS: Most of the subjects were not professional artists, and represented many fields; temperament might be different in different art fields. CONCLUSIONS: Euthymic BP, MDD, and CC compared to HC, had prominent temperamental commonalities. However, BP and CC had the additional commonality of increased openness compared to HC. BP had particularly high Cyclothymia scores that were significantly higher then those of MDD. The prominent BP-CC overlap suggests underlying neurobiological commonalities between people with mood disorders and individuals involved in creative disciplines, consistent with the notion of a temperamental contribution to enhanced creativity in individuals with bipolar disorders.     

High harm avoidance and low self-directedness in euthymic young adults with recurrent, early-onset depression

BACKGROUND: The personality dimensions of harm avoidance (HA) and self-directedness (SD), as measured by the Temperament and Character Inventory (TCI), have been widely associated with depression and there is preliminary evidence that they may represent trait markers for depression. However, many studies in this area are limited by the use of heterogeneous samples of depressed patients and by the confounding effect of depressed mood during personality testing. The current study compares TCI personality dimension scores in a group of euthymic young adults with recurrent early-onset major depressive disorder (RE-MDD) to well-matched euthymic controls. METHODS: Fifty-two young adults with a past history of RE-MDD were recruited from consecutive referrals to a psychiatric clinic at a university health service. Eighty nine controls were also recruited. Euthymia was established in patients by a score of less than 9 on the Hamilton Rating Scale for Depression (HRSD) and in controls by a Becks Depression Inventory (BDI) score of less than 10. All participants completed the TCI-125. RESULTS: Patients and controls were well matched in terms of sociodemographic profile. Euthymic RE-MDD patients scored significantly higher than controls on the temperament dimension of harm avoidance (HA; mean score 14.5 versus 7.8, p<0.0001) and significantly lower than controls on the character dimension of self-directedness (SD; mean score 14.1 versus 19.9, p<0.0001). Covariance analysis suggested that both HA and SD contributed independently to the familial risk of depression. LIMITATIONS: Subjects and controls all came from relatively affluent social backgrounds-these findings may not generalise to more socioeconomically diverse populations. The possibility of a 'scarring effect' of depressive episodes on self-reported personality dimension scores cannot be excluded. CONCLUSIONS: High HA and low SD represent trait markers for liability to recurrent major depressive disorder in young adults. Further research is needed to replicate these findings and to assess the contribution that the experience of depressive episodes makes to self-reported personality dimension scores.     

An Affect-Based,Hierarchical Model of Temperament and Its Relations With Internalizing Symptomatology

Examined the tripartite model of personality, which emphasizes negative affectivity (NA) and positive affectivity (PA) as central organizing dimensions of personality that are useful for discriminating psychopathologies. Conceptualizations of youth temperament also include second-order, organizing factors of negative emotionality/ neuroticism and positive emotionality/extroversion that may differentially predict psychopathologies. A community sample of 290 10- to 17-year-old youth completed the Emotionality, Activity, and Sociability Temperament Survey (EAS), Positive and Negative Affectivity Schedule, and measures of symptoms of anxiety and depression. Factor analysis replicated the 5-factor structure of the EAS and revealed 2 independent second-order factors, negative temperament (NT) and positive temperament (PT). NT and PT demonstrated convergent and discriminant relations with NA and PA. Consistent with the tripartite model, NT was associated with both anxiety and depression scores, but PT was related to depression scores only.     

Five-factor personality traits in patients with seasonal depression: treatment effects and comparisons with bipolar patients.

BACKGROUND: Increasingly, the Five Factor Model (FFM) of personality is being used to assess personality characteristics of patients with Axis I disorders. Recent study indicates that patients with the seasonal subtype of major depression (SAD) may differ meaningfully from other depressed patients. In the present study, we further examined this finding, with attention to the stability of personality characteristics across treatment. METHODS: We used the NEO-FFM to assess the personality characteristics of two samples of depressed outpatients: patients with SAD and patients with bipolar disorder. Assessment was repeated in the SAD patients after light therapy. RESULTS: Consistent with previous research, we found elevated scores on the Openness domain in the SAD patients. SAD patients also scored significantly lower on Neuroticism and significantly higher on the Conscientiousness and Extroversion domains than patients with bipolar disorder. Scores on the Openness domain remained elevated after treatment of SAD; this occurred in the context of significant decreases in Neuroticism and increases in Extroversion scores. LIMITATIONS: These results were obtained in a relatively small-sample study. Although our sample of bipolar patients were taking mood stabilizers, it is unlikely that medication effects could explain our results. CONCLUSIONS: Our findings are consistent with those reported by Bagby et al. (Major depression and the five-factor model of personality. J. Pers. Disord. 1995;9:224-234) and suggests that Neuroticism and Extroversion are the FFM domains most responsive to treatment for depression. Our results also suggest that elevations on the Openness domain do not change with treatment and may be an enduring characteristic of patients with SAD.     

Different personalities between depression and anxiety

We examined the different personality dimensions between depression and anxiety with Cloninger's seven-factor model of temperament and character. The Temperament and Character Inventory (TCI), which measures four temperament and three character dimensions of Cloninger's personality theory (125-item short version), the Self-rating Depression Scale (SDS), and the State-Trait Anxiety Inventory (STAI) were administered to 223 Japanese students. With hierarchical regression analysis, the SDS score was predicted by scores of Harm-Avoidance, Self-Directedness, and Self-Transcendence, even after controlling for the STAI score. The STAI score was predicted by scores of Self-Directedness and Cooperativeness, even after controlling for the SDS score. More importance should be attached to these dimensions of character because they might contribute to both depression and anxiety. © 1998 John Wiley & Sons, Inc. J Clin Psychol 54: 1043–1051, 1998.     

Dysthymic and anxiety-related personality traits in bipolar spectrum illness

Anxious and dysthymic personality traits were measured in a euthymic, familial sample of bipolar (BPD) individuals and their affectively ill and unaffected relatives. According to the quantitative genetic model of bipolar spectrum illness [Evans, L., Akiskal, H.S., Keck, Jr., P.E., McElroy, S.L., Sadovnick, A.D., Remick, R.A., Kelsoe, J.R., 2005. Familiality of temperament in bipolar disorder: support for a genetic spectrum. J. Affect. Disord. 85, 153-168], these traits should be normally distributed with the bipolar disorder I (BPD I) group showing the highest and the unaffected relatives the least "pathological" scores. Three hundred individuals from 47 bipolar disorder families were administered a battery of personality questionnaires (Temperament Evaluation of Memphis, Pisa, Paris, and San Diego; Temperament and Character Inventory; Affective Neuroscience Personality Scale) as well as a self-rating depression (Beck Depression Inventory) and mania (Altman Self-Rating Mania) scale. Out of the 300 participants, 58 were diagnosed with BPD I, 27 with bipolar disorder II (BPD II), 58 with recurrent major depression (MDE-R), 45 had one previous depressive episode (MDE-S), and 88 were unaffected. The BPD I group scored significantly higher than their unaffected relatives on the Harm Avoidance and Sadness scales of the TCI and ANPS, respectively, while the MDE-R but not the BPD samples scored significantly higher than unaffected relatives on the Anxious Temperament (AT) subscale of the TEMPS-A. In general, the mean dysthymic personality scores were highest in the BPD sample, followed by the MDE-R, MDE-S, and unaffected relative groups. Nevertheless, no significant personality differences were found between the psychiatrically-ill groups. While dysthymic temperament traits conform relatively well to the quantitative genetic model of affective illness, anxious traits as defined by the AT scale, are equally salient in BPD and unipolar depression.     

父亲在位与大学生人格特点的关系

目的:探讨父亲在位与大学生人格特点的关系。方法:采用方便取样法,使用父亲在位问卷中文修订版(FPQ-R)和中国大五人格问卷简式版(CBF-PI-B)对532名大学生进行调查。结果:①父亲在位各因子与大学生人格的严谨性、开放性、宜人性、外向性之间呈正相关(r=0.07～0.30),与神经质之间呈负相关(r=-0.09～-0.27)。②父亲与祖父的关系、母亲对父子关系的支持对大学生人格的神经质有显著负向预测作用;父母关系、父亲与祖父的关系和父亲影响的概念对严谨性有显著正向预测作用;父母关系、父亲影响的概念对宜人性有显著正向预测作用;与父亲的身体互动、父亲影响的概念对开放性有显著正向预测作用;父亲参与的感知、母亲和外祖父的关系对外向性有显著正向预测作用。结论:父亲在位对大学生人格有显著影响。     

Personality differences in attempted suicide versus suicide in adults 50 years of age or older

The authors tested hypotheses concerning personality differences in treatment-seeking suicide attempters (AT; n = 60) and a community sample of suicides (SU; n = 43) over age 50. On the basis of prior research, the authors hypothesized that SU would be lower in Neuroticism and Openness and higher in Conscientiousness. A 2-group (AT vs. SU) multivariate analysis of covariance with NEO Personality Inventory--Revised (Informant Version) domain scores as dependent variables revealed that SU were lower in Neuroticism and higher in Conscientiousness. The authors conclude that AT and SU in this age group can be distinguished on the basis of informant ratings of personality traits. These differences can inform risk detection.     

Big five personality factors related to face recognition

The present study examined whether scores on big five personality factors correlated with face-recognition response time in visual search paradigm. Sixty adjectives were used to measure personality scores of 60 participants along the five factors of Extroversion, Neuroticism, Openness to Experience, Agreeableness, and Conscientiousness. Picture of human faces or geometrical figures in a 4 x 4 array were used as stimuli. The sixteen faces or figures were either identical (absent condition) or one randomly placed target with 15 identical distracters (present condition). Participants were asked to respond 'present' or 'absent' as fast and accurately as possible. Results showed that the response time differed significantly between high and low groups of each personality factor except Agreeableness. For Extroversion, Neuroticism, and Conscientiousness, the response time difference was observed only for human face recognition. The results suggested that personality differences and face recognition were related.     

The influence of depressive state features on trait measurement

BACKGROUND: Certain personality characteristics may change during depression, reflecting temporary states, while others remain stable. This study investigates the stability of personality during depression. Identification of depression-sensitive personality traits may help to elucidate the mechanisms that influence course and outcome of depression. METHODS: For 42 ambulatory and 38 day care patients with a depressive disorder, depression severity and personality characteristics were measured repeatedly during a 12 week-period. The total HDRS score was indicative of depression severity, while the NEO-FFI was used for measurement of basic personality traits and the IPS for depression-specific traits. RESULTS: In 12 weeks, depression severity significantly decreased for both patient groups. The Big Five traits Neuroticism and Extraversion and all but one aspect of Interpersonal sensitivity showed depression-related changes towards the normal range. Openness, Altruism and Conscientiousness remained stable. LIMITATIONS: The number of patients excluded from the study due to missing data is substantial. Furthermore, it was not possible to control for treatment influence due to a double-blind design. CONCLUSIONS: Neuroticism, Extraversion and Interpersonal sensitivity scores are likely to reflect state components during a depression, while the stability of Openness, Conscientiousness and Altruism scores indicates pure personality traits.     

Systematic clinical methodology for validating bipolar-II disorder: data in mid-stream from a French national multi-site study (EPIDEP)

Background: This paper presents the methodology and clinical data in mid-stream from a French multi-center study (EPIDEP) in progress on a national sample of patients with DSM-IV major depressive episode (MDE). The aim of EPIDEP is to show the feasibility of validating the spectrum of soft bipolar disorders by practising clinicians. In this report, we focus on bipolar II (BP-II). Method: EPIDEP involves training 48 French psychiatrists in 15 sites; construction of a common protocol based on the criteria of DSM-IV and Akiskal (Soft Bipolarity), as well as criteria modified from the work of Angst (Hypomania Checklist), the Ahearn-Carroll Bipolarity Scale, HAM-D and Rosenthal Atypical Depression Scale; Semi-Structured Interview for Evaluation of Affective Temperaments (based on Akiskal-Mallya), self-rated Cyclothymia Scale (Akiskal), family history (Research Diagnostic Criteria); and prospective follow-up. Results: Results are presented on 250 (of the 537) MDE patients studied thus far during the acute phase. The rate of BP-II disorder which was 22% at initial evaluation, nearly doubled (40%) by systematic evaluation. As expected from the selection of MDE by uniform criteria, inter-group comparison between BP-II vs unipolar showed no differences on the majority of socio-demographic parameters, clinical presentation and global intensity of depression. Despite such uniformity, key characteristics significantly differentiated BP-II from unipolar: younger age at onset of first depression, higher frequency of suicidal thoughts and hypersomnia during index episode, higher scores on Hypomania Checklist and cyclothymic and irritable temperaments, and higher switching rate under current treatment. Eighty-eight percent of cases assigned to cyclothymic temperament by clinicians (with a cut-off of 10/21 items on self-rated cyclothymia) were recognized as BP-II. Evaluation of this temperament by clinician and patient correlated at a highly significant level (r=0.73; p<0.0001). Cyclothymia and hypomania were also correlated significantly (r=0.51; p<0.001). Limitation: In a study conducted in diverse clinical settings, it was not possible to assure that clinicians making affective diagnoses were blind to the various temperamental measures. However, bias was minimized by the systematic and/or semi-structured nature of all evaluations. Conclusion: With a systematic search for hypomania, 40% of major depressive episodes were classified as BP-II, of which only half were known to the clinicians at study entry. Cyclothymic temperamental dysregulation emerged as a robust clinical marker of BP-II disorder. These data indicate that clinicians in diverse practice settings can be trained to recognize soft bipolarity, leading to changes in diagnostic practice at a national level.     

Bipolar disorder: I. Temperament and character

BACKGROUND: The nature of the relationship between personality and bipolar affective disorders is an important but unanswered question. METHODS: We have studied personality in bipolar patients by using the Temperament and Character Inventory (TCI). TCI were administered to 100 euthymic bipolar patients and 100 controls from the normal population. RESULTS: Bipolar patients were significantly higher in harm avoidance (HA) and lower in reward dependence (RD), self-directedness (SD), and cooperativeness (CO) than controls. Bipolar patients are more fatigable, less sentimental, more independent, less purposeful, less resourceful, less empathic, less helpful, less pure-hearted, and have less impulse control than controls. Bipolar II patients are more impulsive, more fatigable, less resourceful, and have less impulse control than bipolar I patients. LIMITATIONS: Our results are limited to euthymic bipolar patients and cannot be generalized to affective disorders. CONCLUSIONS: Even when clinically euthymic on lithium maintenance, bipolar patients continue to have a characteristic cognitive deficit. This is in agreement with cognitive theories about cognitive deficits in depression that are regarded as important vulnerability factors in mood disorders.     

Similarity in temperament between mother and offspring rhesus monkeys: sex differences and the role of monoamine oxidase-a and serotonin transporter promoter polymorphism genotypes

Temperament is usually considered biologically based and largely inherited, however, the environment can shape the development of temperament. Allelic variation may confer differential sensitivity to early environment resulting in variations in temperament. Here we explore the relationship between measures of temperament in mothers and their first-born offspring and the role of genetic sensitivity in establishing the strength of these associations. Temperament ratings were conducted on 3- to 4-month-old rhesus monkeys after a 25-hr biobehavioral assessment. Factor analysis revealed a four-factor structure of temperament. Females assessed as infants have reproduced and their offspring have also been evaluated through the standardized testing paradigm. Canonical correlation analysis revealed statistically significant associations between factor scores of mothers and sons, but not mothers and daughters. Further, offspring possessing the high activity, "low risk," alleles of the rhMAOA-LPR or rh5-HTTLPR showed statistically significant canonical correlations, whereas those possessing other alleles did not, suggesting differential genetic sensitivity to the normative early experience of maternal temperament.     

Relationship between personality trait and regional cerebral glucose metabolism assessed with positron emission tomography

There have been no studies systematically investigating relationships between biogenetic temperament dimensions and patterns of brain glucose metabolism. Nineteen healthy subjects were evaluated regarding the biogenetic temperament using Cloninger's Temperament and Character Inventory (TCI). In addition, [¹⁸F] fluorodeoxyglucose (FDG) positron emission tomography (PET) was used to measure regional brain glucose metabolism. Voxel-based correlation analysis was used to test correlations between regional brain glucose metabolism and scores on the TCI. We identified that each temperament dimension, such as Novelty Seeking, Harm Avoidance, and Reward Dependence, was significantly correlated with specific brain regions. The majority of correlations were observed in the areas of paralimbic regions and temporal lobes. The current study provides evidence linking each biogenetic temperament dimension with specific brain areas and provides a promising base for future personality research.     

Exploring the margins of the bipolar spectrum: temperamental features of the typus melancholicus

BACKGROUND: Both the melancholic type of personality (TM) and the concept of temperament offer promising insights for the phenotypic characterization of mood-spectrum vulnerability. This research challenges the theoretical hiatus between the two psychopathological paradigms--the phenomenological and the neo-Kraepelinian--by means of an empirically-based approach. METHOD: Temperamental features were assessed through the Semi-structured Affective Temperament Interview (TEMPS-I) in an outpatient population of 116 clinically stable, euthymic subjects who suffered from a DSM IV major depressive disorder, previously enrolled for a study on the characteristics of major/unipolar depressive episode. The sample was subsequently evaluated and dichotomized according to the Criteria for Typus Melancholicus (CTM). RESULTS: The TM subjects exhibited statistically significant differences in the temperamental profile as compared to non-TMs (NTM). A specific association between TM and hyperthymic temperament (HT) was confirmed by binary logistic regression analysis, suggesting that the phenomenological distinction TM vs. NTM is supported by different predisposing Kraepelinian "fundamental states". LIMITATION AND CONCLUSIONS: Although it is uncertain whether the findings would generalize outside the Italian culture, they nonetheless delineate a strong aggregation between TM and hyperthymic temperament, indicating that (1) an integrative neo-Kraepelinian/phenomenological cooperative model is warranted to tap the complexity of the phenotypic diathesis for mood-disorders, and (2) the hyperthymic-melancholic type of personality rests on the margins of the bipolar spectrum. The main limitation of this study is that it enrolled a selected outpatient volunteer sample. A large scale study in general population is needed to confirm the hypothesis of a strong link between TM and HT and to shed light on the causes and meanings of this association.     

An investigation of psychological sense of community in relation to Big Five personality traits

In this study we examine the relationship between psychological sense of community (PSC) and Big Five personality traits as well as absences from school. Based on samples of 646 high school students and 355 undergraduate college students, PSC was significantly related to Extraversion, Agreeableness, Conscientiousness, and Neuroticism in both samples and to Openness and Absences in the high school sample. Results of stepwise multiple regression analyses showed that the Big Five variables accounted for 25% of the variance in PSC for the high school sample and 21% for the college sample. Openness, PSC, and Neuroticism significantly entered a regression equation to predict Absences. These findings indicate substantial overlap between PSC and Big Five personality traits, raising the question of whether there are any community‐level effects for PSC above and beyond personality. Our results are discussed in terms of consistency with sense of community definitions, person‐environment issues, and directions for future research. © 2003 Wiley Periodicals, Inc. J Comm Psychol 31: 531–541, 2003.