Temperament in child and adolescent offspring of patients with schizophrenia and bipolar disorder

Risk factors for mood disorders among offspring of parents with bipolar disorder: Findings from a discordant-sibling study

The purpose of this naturalistic, prospective study was to identify risk factors for mood disorders in offspring of parents with bipolar disorder (BPD) using the discordant-sibling design by comparing premorbid psychopathology or symptoms, temperament, personality traits and coping style as well as the perception of family-related characteristics among affected and unaffected siblings within the same family. This approach controls for confounding by unmeasured genetic and environmental factors shared within families. Our sample comprised 24 families of a parent with BPD with at least one child that developed BPD or major depressive disorder (n = 31), and at least one child who did not. Offspring were followed for a mean duration of 16.2 (s.d: 4.6) years. Information was collected from the offspring themselves. Generalized linear mixed models only revealed differences in three dimensions of the Dimension of Temperament Survey-Revised (DOTS-R) version: Offspring with mood disorders scored higher on "Approach-withdrawal", "Rhythmicity for daily habits", and "Task orientation" than their unaffected siblings. The higher scores, and not lower scores as expected, on these temperament dimensions observed in offspring that subsequently developed mood disorders may reflect increased vulnerability, but they could also mirror premorbid mood swings or strategies to cope with them.

Experiences of helplessness and fear among caregivers diagnosed with severe mental illness and co-caregivers: The Danish High Risk and Resilience Study - VIA 7

This study investigates indicators of disorganized caregiving among caregivers of children who have a familial predisposition of schizophrenia spectrum psychosis (SZ) or bipolar disorder (BP), and whether indicators of disorganized caregiving are associated with the caregivers' and children's level of functioning as well as the children's internalizing and externalizing behavior problems. Indicators of disorganized caregiving were assessed with the Caregiving Helplessness Questionnaire (CHQ). Level of functioning was evaluated using the Children's Global Assessment Scale and the Personal and Social Performance Scale, while dimensional psychopathology were measured with the Child Behavior Checklist. 185 caregivers belonging to a SZ combined group (i.e., SZ-I + SZ co-caregiver), 110 caregivers to a BP combined group (i.e., BP-I + BP co-caregiver), and 184 caregivers to a population-based control group provided data on CHQ. Having a history of SZ or BP or being a co-caregiver to a parent with SZ or BP was associated with higher levels of experiences of helplessness and fear. Higher scores on helplessness were associated with lower level of functioning among caregivers and children and with children having externalizing/internalizing behavior problems. These results emphasize the need for interventions addressing indicators of disorganized caregiving in families with SZ or BP.

Temperament and adolescent suicide attempts: a case-control study with multi-ethnic Asian adolescents

BACKGROUND

Suicide is the leading cause of death for adolescents in several parts of Asia, including Singapore. This study examines the relationship between temperament and youth suicide attempts in a sample of multi-ethnic Singaporean adolescents.

METHODS

A case-control design compared 60 adolescents (Mage = 16.40, SDage = 2.00) with a recent suicide attempt (i.e., past 6 months) with 58 adolescents (Mage = 16.00, SDage = 1.68) without any history of suicide attempts. Presence of suicide attempts was established using the semi-structured interviewer-administered Columbia Suicide Severity Rating Scale. Participants also completed self-report measures on temperament traits, psychiatric diagnoses, stressful life events, and perceived parental rejection in an interview-based format.

RESULTS

Psychiatric comorbidity, recent stressful life events, perceived parental rejection, and all five "difficult temperament" traits, were significantly overrepresented among adolescent cases relative to healthy controls. Adjusted logistic regression models revealed significant associations between suicide attempt, MDD comorbidity (OR: 10.7, 95% Cl: (2.24-51.39)), "negative mood" trait (OR: 1.12-1.18, 95% Cl: (1.00-1.27)), and the interaction term of "positive mood" and "high adaptability" traits (OR: 0.943 - 0.955, 95% Cl: (0.900 - 0.986)). Specifically, "positive mood" predicted lower likelihood of a suicide attempt when "adaptability" was high (OR: 0.335 - 0.342, 95% Cl: (0.186 - 0.500)) but not low (OR: 0.968 - 0.993, 95% Cl: (0.797 - 1.31)).

CONCLUSION

Temperament screening may be important to identify adolescents at higher or lower risk of suicide at an early stage. More longitudinal and neurobiological research converging on these temperament findings will be helpful in ascertaining temperament screening as an effective suicide prevention methodology for adolescents.

Correlation of temperament characteristics and early functional exercise compliance in school-age children with limb fractures: Implication for clinical nursing care

Early functional exercise plays a very important role in the rehabilitation and nursing care of children with fractures. We aimed to evaluate the role of temperament characteristics in the early functional exercise compliance in school-age children with limb fractures, to provide evidence to clinical nursing care. School-age children with limb fractures admitted to our hospital from January 1, 2021 to June 30, 2022 were selected. We collected the general information, evaluated the temperament characteristics and their functional exercise compliance in school-age children. Correlation and regression analyses were conducted to assess the correlation of temperament characteristics and early functional exercise compliance. A total of 126 school-age children with limb fractures were finally included. There were 68, 36, and 22 children that were rated as easy-going, troublesome and initiate slow temperament, respectively. The children with easy-going temperament had the best early functional exercise compliance, followed by children with initiate slow temperament, and compliance of children with troublesome temperament was the worst. The reaction intensity factor in the temperament characteristics of school-age children with fracture was negatively correlated with early functional exercise compliance (P = .007). Reaction intensity was a risk factor for early functional exercise compliance in school-age children with fractures (P = .004). Health care providers must consider the influence of temperament characteristics on compliance in school-age children with fractures, and take targeted nursing measures according to different temperament characteristics of children to improve early functional exercise compliance in school-age children with fractures, so as to improve the functional recovery and prognosis of children.

Temperament Profiles of Children and Adolescents with Psychotic and Mood Disorders

BACKGROUND

Psychiatric disorders are often linked to dysfunctions within neurotransmitter systems, and the same systems play a role in healthy temperaments. Development of a common bio-behavioural taxonomy based on functionality of neurotransmitter systems suggests examining temperament profiles in patients with various psychiatric disorders.

OBJECTIVE

(1) To investigate temperament profiles in two age groups of children with delusional disorders; (2) to investigate temperament profiles in adolescents with mood disorders; (3) to investigate temperament profiles in in vitro fertilisation (IVF) children.

METHODS

Sample: in total 171 participants (M/F = 91/80), healthy children and teenagers (volunteers); two age groups of children with psychotic disorders; teens with mood disorders (clients of the Federal Mental Health Center) and healthy IVF. Parents of participants completed a test based on the neurochemical model Functional Ensemble of Temperament (FET).

RESULTS AND CONCLUSIONS

(1) Both age groups of children with psychotic disorders had significantly lower scores on the scales of physical endurance, tempo, plasticity, and self-satisfaction, in comparison to healthy controls; the psychotic group aged 5-11 had also lower scores on the impulsivity scale, whereas the psychotic group 12-17 had lower scores on the social endurance and social tempo scales and higher neuroticism. (2) Teens with mood disorders had lower scores on the self-confidence-satisfaction scale and higher scores on the impulsivity scale, in comparison to controls. (3) No difference between IVF and naturally conceived children were found. The results show the benefits of using the FET framework for structuring the correspondence between psychiatric disorders and temperament as it differentiates between social versus physical aspects of behaviour and orientational versus executive aspects.

An Integrated Account of Expert Perspectives on Functioning in Schizophrenia

An integrated and interdisciplinary care system for individuals with schizophrenia is essential, which implies the need for a tool that assesses the difficulties and contextual factors of relevance to their functioning, and facilitates coordinated working across the different professions involved in their care. The International Classification of Functioning, Disability and Health Core Sets (ICF-CS) cover these requirements. This study aimed to evaluate the content validity of the ICF-CSs for schizophrenia from the perspective of experts. Six three-round Delphi studies were conducted with expert panels from different professional backgrounds which have played a significant role in the treatment of individuals with schizophrenia (psychiatry, psychology, nursing, occupational therapy, social work and physiotherapy). In total, 790 experts from 85 different countries participated in the first round. In total, 90 ICF categories and 28 Personal factors reached expert consensus (reached consensus from four or more professional perspectives). All the categories in the brief version of the ICF-CS for schizophrenia reached consensus from all the professional perspectives considered. As for the comprehensive version, 89.7% of its categories reached expert consensus. The results support the worldwide content validity of the ICF-CSs for schizophrenia from an expert perspective and underline the importance of assessing functioning by considering all the components implied.

Personality and pediatric bipolar disorder: Toward personalizing psychosocial intervention

BACKGROUND

Previous research suggests that challenging temperament characteristics (i.e., low mood, irritability and rigidity) are associated with risk for the development of Pediatric Bipolar Disorder (PBD). This study aimed to investigate the connection between PBD and discrete dimensions of the Five Factor Model (FFM) of personality.

METHODS

Youth diagnosed with PBD I, II, or NOS, at high risk for the disorder (BD-HR) and healthy controls were recruited from the Child and Adolescent Psychiatry Outpatient Clinic at Stanford University School of Medicine. Researchers administered a personality inventory and evaluated current mood state.

RESULTS

BD and BD-HR youth scored lower in Emotional Regulation than did HC youth (F (3, 70) = 10.75, p < .001). Within the BD and BD-HR groups, youth with high depression scores scored lower on Extraversion (F (3, 70) = 8.62, p < .001) and Conscientiousness (F (3, 70) = 4.53, p < .01).

LIMITATIONS

A major limitation of this study is its cross-sectional design, precluding analysis of whether certain traits or clusters of traits predict PBD or other mood disorders.

CONCLUSIONS

Low Emotional Regulation, Conscientiousness, and Agreeableness were associated with PBD; this personality profile clinically corresponds with youth diagnosed with PBD who present with difficulty regulating their emotions, vulnerability to stress, and emotional reactivity. Future research examining personality characteristics in PBD may elucidate further a specific profile to aid clinicians in developing psychosocial interventions for youth with and at high risk of developing PBD.

Functioning in schizophrenia from the perspective of psychologists: A worldwide study

Schizophrenia is a severe mental disorder associated with impairment in functioning. A multidisciplinary approach is essential to help individuals with this health condition, and psychological interventions are considered a priority. The International Classification of Functioning, Disability and Health (ICF) offers a theoretical framework for assessing functioning and disability. The ICF Core Sets for schizophrenia are a list of ICF categories describing the most common problems in functioning of persons affected by this health condition. This study aimed to explore the content validity of these ICF Core Sets and to identify the most common problems in people with schizophrenia from the perspective of psychologists. Psychologists with experience of schizophrenia treatment were recruited for a three-round Delphi study in order to gather their views regarding the problems commonly presented by these patients. A total of 175 psychologists from 46 countries covering the six WHO regions answered the first-round questionnaire, and 137 completed all three rounds. The 7,526 concepts extracted from first-round responses were linked to 412 ICF categories and 53 personal factors. Consensus (≥75% agreement) was reached for 76 ICF categories and 28 personal factors. Seventy-three of the 97 ICF categories that form the Comprehensive ICF Core Set for schizophrenia achieved consensus, and only three categories that yielded consensus do not feature in this Core Set. These results support the content validity of these ICF Core Sets from the perspective of psychologists. This provides further evidence of the suitability of the ICF framework for describing functioning and disability in persons with schizophrenia.