Temperamental and character profiles of preschool children with ODD, ADHD, and anxiety disorders

Cluster analysis of teachers report for identifying symptoms of autism spectrum and/or attention deficit hyperactivity in school population: EPINED study

An early detection of Neurodevelopmental Disorders (NDDs) is crucial for their prognosis; however, the clinical heterogeneity of some disorders, such as autism spectrum disorder (ASD) or attention-deficit hyperactivity disorder (ADHD) is an obstacle to accurate diagnoses in children. In order to facilitate the screening process, the current study aimed to identify symptom-based clusters among a community-based sample of preschool and school-aged children, using behavioral characteristics reported by teachers. A total of 6894 children were assessed on four key variables: social communication differences, restricted behavior patterns, restless-impulsiveness, and emotional lability (pre-schoolers) or inattention and hyperactivity-impulsivity (school-aged). From these behavioral profiles, four clusters were identified for each age group. A cluster of ASD + ADHD and others including children with no pathology was clearly identified, whereas two other clusters were characterized by subthreshold ASD and/or ADHD symptoms. In the school-age children, the presence of ADHD was consistently observed with ASD patterns. In pre-schoolers, teachers were more proficient at identifying children who received a diagnosis for either ASD and/or ADHD from an early stage. Considering the significance of early detection and intervention of NDDs, teachers' insights are important. Therefore, promptly identifying subthreshold symptoms in children can help to minimize consequences in social and academic functioning.

Association of temperament and character traits with ADHD and its comorbidities

BACKGROUND

Increasing evidence suggests that personality traits may be associated with ADHD and comorbid concerns. We investigated temperament and character traits associated with internalizing and externalizing comorbidities in adolescents with or without ADHD.

METHODS

The population consisted of a subsample (n = 457) of the Northern Finland Birth Cohort 1986 (NFBC1986) that comprised 16-year-old adolescents with and without symptoms of ADHD. ADHD and psychiatric comorbidities were assessed using the Kiddie-SADS-PL and temperament and character profiles were determined with TCI-125. Outcomes were examined using Pearson's chi-square test, Analyses of Covariance and Cohen's d.

RESULTS

The adolescents with ADHD endorsed more novelty seeking and less persistence, self-directedness, and cooperativeness than those without. Comparison of the personality traits and psychiatric comorbidities with the ADHD cases showed that comorbidities did not particularly affect the temperament and character profiles, but rather ADHD accounted for the differences between the personality traits. However, the temperament and character traits predicted externalizing and internalizing psychiatric disorders in the control group.

CONCLUSIONS

Our findings reveal unique comorbidity-related temperament factors, which may have implications for adaptive and personalizing intervention efforts.

Probing the overarching continuum theory: data-driven phenotypic clustering of children with ASD or ADHD

The clinical validity of the distinction between ADHD and ASD is a longstanding discussion. Recent advances in the realm of data-driven analytic techniques now enable us to formally investigate theories aiming to explain the frequent co-occurrence of these neurodevelopmental conditions. In this study, we probe different theoretical positions by means of a pre-registered integrative approach of novel classification, subgrouping, and taxometric techniques in a representative sample (N = 434), and replicate the results in an independent sample (N = 219) of children (ADHD, ASD, and typically developing) aged 7-14 years. First, Random Forest Classification could predict diagnostic groups based on questionnaire data with limited accuracy-suggesting some remaining overlap in behavioral symptoms between them. Second, community detection identified four distinct groups, but none of them showed a symptom profile clearly related to either ADHD or ASD in neither the original sample nor the replication sample. Third, taxometric analyses showed evidence for a categorical distinction between ASD and typically developing children, a dimensional characterization of the difference between ADHD and typically developing children, and mixed results for the distinction between the diagnostic groups. We present a novel framework of cutting-edge statistical techniques which represent recent advances in both the models and the data used for research in psychiatric nosology. Our results suggest that ASD and ADHD cannot be unambiguously characterized as either two separate clinical entities or opposite ends of a spectrum, and highlight the need to study ADHD and ASD traits in tandem.

A Systematic Review of Multiple Family Factors Associated with Oppositional Defiant Disorder

Oppositional Defiant Disorder (ODD) is characterized by a recurrent pattern of angry/irritable emotional lability, argumentative/defiant behavior, and vindictiveness. Previous studies indicated that ODD typically might originate within a maladaptive family environment, or was at least maintained within such an environment. As such, the present review summarized pertinent research from the last 20 years that focused on the pathways connecting family risk factors to the development of child ODD symptoms. A systematic search of electronic databases was completed in August 2020, resulting in the inclusion of 62 studies in the review. The review established a multi-level framework to describe the mechanisms underlying the pathway from familial factors to ODD psychopathological symptoms: (a) the system level that is affected by the family's socioeconomic status and family dysfunction; (b) the dyadic level that is affected by conflict within the marital dyad and parent-child interactions; and (c) the individual level that is affected by parent and child factors. Additionally, from the perspective of family systems theory, we pay special attention to the interactions among and between the various levels of the pathway (moderation and mediation) that might be associated with the occurrence and severity of ODD symptoms. Considering future prevention and intervention efforts, this three-level model emphasizes the necessity of focusing on familial risk factors at multiple levels and the mechanisms underlying the proposed pathways.

Systematic Review and Meta-analysis: The Science of Early-Life Precursors and Interventions for Attention-Deficit/Hyperactivity Disorder

OBJECTIVE

To evaluate which early neurocognitive and behavioral precursors are associated with the development of attention-deficit/hyperactivity disorder (ADHD) and whether these are currently targeted in early interventions.

METHOD

We conducted 2 systematic reviews and meta-analyses of empirical studies to examine the following: (1) early-life (0-5 years) neurocognitive and behavioral precursors associated with familial likelihood for ADHD, an early ADHD diagnosis/elevated ADHD symptoms, and/or the presence of later-childhood ADHD; and (2) interventions delivered to children aged 0 to 5 years targeting the identified precursors or measuring these as outcomes. Standardized mean differences (Hedges' g) and pre-post-treatment change scores (SMD) were computed.

RESULTS

A total of 149 studies (165,095 participants) investigating 8 neurocognitive and behavioral domains met inclusion criteria for part 1. Multi-level random-effects meta-analyses on 136 studies revealed significant associations between ADHD and poorer cognitive (g = -0.46 [95% CIs: -0.59, -0.33]), motor (g = -0.35 [CIs: -0.48, -0.21]) and language (g = -0.43 [CIs: -0.66, -0.19]) development, social (g = 0.23 [CIs: 0.03, 0.43]) and emotional (g = 0.46 [CIs: 0.33, 0.58]) difficulties, early regulatory (g = 0.30 [CIs: 0.18, 0.43]) and sleep (g = 0.29 [CIs: 0.14, 0.44]) problems, sensory atypicalities (g = 0.52 [CIs: 0.16, 0.88]), elevated activity levels (g = 0.54 [CIs: 0.37, 0.72]), and executive function difficulties (g = 0.34 [CIs: 0.05, 0.64] to -0.87 [CIs: -1.35, -0.40]). A total of 32 trials (28 randomized, 4 nonrandomized, 3,848 participants) testing early interventions that targeted the identified precursors met inclusion criteria for part 2. Multi-level random-effects meta-analyses on 22 studies revealed significant intervention-related improvements in ADHD symptoms (SMD = 0.43 [CIs: 0.22, 0.64]) and working memory (SMD = 0.37 [CIs: 0.06, 0.69]).

CONCLUSION

Children aged 0 to 5 years with current or later-emerging ADHD are likely to experience difficulties in multiple neurocognitive/behavioral functions. Early interventions show some effectiveness in reducing ADHD symptoms, but their effects on neurocognitive/behavioral difficulties require further study.

Can Temperament and Character Traits Be Used in the Diagnostic Differentiation of Children With ADHD?

ABSTRACT

In this study, it was aimed to determine the contributions of temperament and character traits to the diagnosis of attention deficit hyperactivity disorder (ADHD) in children. Thirty-six patients between the ages of 9 and 14 with a diagnosis of combined type ADHD and 39 healthy children were included in the study. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-Turkish Version and the Turgay DSM-IV Disruptive Behavior Disorders Rating Scale parent form were used to assess hyperactivity/impulsivity and inattentiveness, and comorbid disorders. The Junior Temperament and Character Inventory-Revised form was used to evaluate temperament-character traits. The classification-based association rules (CBARs) method was used for finding rules predicting ADHD accurately. Low persistence and self-directedness scores, and higher disorderliness and fatigability subgroup scores were found in the ADHD group. In CBARs, the separation of children with ADHD from healthy controls could be made with 0.83 accuracy, 0.80 sensitivity, and 0.86 specificity. The results of our study support the view that temperament-character traits can help clinical diagnosis of ADHD.

Developmental Factors That Predict Head Movement During Resting-State Functional Magnetic Resonance Imaging in 3-7-Year-Old Stuttering and Non-stuttering Children

Early childhood marks a period of dynamic neurocognitive development. Preschool-age coincides with the onset of many childhood disorders and is a developmental period that is frequently studied to determine markers of neurodevelopmental disorders. Magnetic resonance imaging (MRI) is often used to explore typical brain development and the neural bases of neurodevelopmental disorders. However, acquiring high-quality MRI data in young children is challenging. The enclosed space and loud sounds can trigger unease and cause excessive head movement. A better understanding of potential factors that predict successful MRI acquisition would increase chances of collecting useable data in children with and without neurodevelopmental disorders. We investigated whether age, sex, stuttering status, and childhood temperament as measured using the Child Behavioral Questionnaire, could predict movement extent during resting-state functional MRI (rs-fMRI) in 76 children aged 3–7 years, including 42 children who stutter (CWS). We found that age, sex, and temperament factors could predict motion during rs-fMRI scans. The CWS were not found to differ significantly from controls in temperament or head movement during scanning. Sex and age were significant predictors of movement. However, age was no longer a significant predictor when temperament, specifically effortful control, was considered. Controlling for age, boys with higher effortful control scores moved less during rs-fMRI procedures. Additionally, boys who showed higher negative affectivity showed a trend for greater movement. Considering temperament factors in addition to age and sex may help predict the success of acquiring useable rs-fMRI (and likely general brain MRI) data in young children in MR neuroimaging.

ADHD and ODD Symptoms in Toddlers: Common and Specific Associations with Temperament Dimensions

The aim of this work was to study the relationship between temperament and signs of psychopathology in typically developing toddlers. More specifically, Attentional Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) symptoms were analyzed in connection with fine-grained temperament dimensions. The sample was composed of 65 toddlers aged between 18 and 35 months. Bivariate correlations showed that higher levels of negative emotionality and approach tendencies, and lower levels of inhibitory control, were related to more ADHD and ODD manifestations. Bivariate correlations also indicated unique associations: lower levels of soothability were associated with higher ODD symptoms, whereas lower attentional focusing and low-intensity pleasure were related with higher ADHD symptoms. Additionally, regression and path analysis models indicated that ADHD was predominantly associated with attentional focusing and motor activation whereas ODD was most closely related to frustration. Our findings highlight the relevance of studying early correlates of psychopathological manifestations to identify children who could benefit from prevention and early intervention programs.

Relations Between Sleep and Temperament in Preschool Children With ADHD

Objective: The objective of this study was to assess the links between temperament and sleep in a group of preschoolers with ADHD. Method: Twenty-five ADHD (M = 5.37 years, SD = 1.09) and 22 typically developing (TD; M = 5.10, SD = 1.18) preschoolers participated in the study. Sleep was assessed with the Sleep Disturbance Scale and wrist actigraphy. The Preschool Temperament and Character Inventory (PsTCI) was used to evaluate the child temperament. Results: ADHD children showed a temperamental profile characterized by higher novelty seeking, lower persistence, self-directness, and cooperativeness and marginally lower harm avoidance (HA) compared with controls. HA was associated negatively to wakefulness after sleep onset and sleep fragmentation and positively with sleep efficiency and sleep time. Reward dependence was negatively associated with wake episode length. Conclusion: Sleep and temperament are correlated in preschoolers with ADHD and temperament might represent an intermediate endophenotype underlying the relation between ADHD and sleep disorders.

If you believe that breaking is possible, believe also that fixing is possible: a framework for ruptures and repairs in child psychotherapy

Safran and Muran's classic theoretical framework of alliance rupture and repair suggests effective techniques for repairing alliance ruptures. Accumulating empirical evidence suggests that successful processes of rupture and repair result in better therapeutic outcome and reduced dropout rates. Although ruptures in the alliance in child psychotherapy are frequent, little is known about how to repair them. The present paper proposes a model for identifying and repairing ruptures in child psychotherapy based on Safran and Muran. It consists of four phases: i) identifying the rupture and understanding its underlying communication message, ii) indicating the presence of the rupture, iii) accepting responsibility over the therapists' part in the rupture and emphasizing the children's active role as communicators of their distress, and iv) resolving the rupture using change strategies and meta-communication by constructing a narrative story. The theoretical rationale of each phase is explained in detail, and practical clinical guidelines are provided. Empirical studies are needed to examine the effectiveness of the proposed framework.

Temperament and character profiles for children with ADHD with and without tic disorders

There is no research about whether ADHD with tic disorder that temperamental features that differ from the ADHD. This research aimed to identify temperament and character profiles for children with ADHD according to tic disorder by comparing them with a healthy control group. A discriminant analysis was conducted to identify whether temperament and character profiles can discriminate comorbidity. The sample consisted of three groups (N = 40 per group): ADHD alone, ADHD with tic disorder and age- and sex- matched healthy control. The parents of 120 children (mean age 8.57 ± 1.71 years) completed the Junior Temperament and Character Inventory (JTCI). The two ADHD groups showed higher novelty seeking and low persistence, self-directedness and cooperativeness than the control group. The ADHD alone group had lower scores for persistence and self-directedness than the other two groups. Temperament and character profiles were useful for discriminating ADHD from the control group. However, their discriminating power was relatively low for all three groups. Results indicated that differences in temperament and character in ADHD children were present according to comorbid tic disorders. JTCI's discriminating power for ADHD alone and ADHD with tic disorder was relatively lower than that of the combined ADHD group and the control group.

Sex differences in the relations between infant temperament and electrodermal responses in early childhood

The present study examines the relationship between sex, infant temperament, and childhood psychophysiological reactivity via electrodermal activity (EDA). Both temperament and EDA are known to be relatively stable traits across the lifespan reflecting individual reactivity and regulation linked to suboptimal behavioral development and risk for psychopathology. However, little is known about the role of sex in the relationship between temperament and EDA. As a part of a larger longitudinal study of behavioral development, 125 participants were followed from birth till 3 years-old to examine the relationship between temperament and psychophysiological reactivity in different gender groups. Measurements of temperament at 6 months-old, and EDA, via skin conductance response (SCR) rate to a series of six startling auditory stimuli at 3 years-old were collected. Median splits of SCR scores and three temperament dimensions (positive affect, negative affect, and regulation) were created to designate high/low groups. Results indicate sex moderated the relationships between temperament traits and SCR rates. Specifically, low positive affect was associated with an increased risk for high psychophysiological reactivity in boys (odds ratio = 3.8), whereas high regulation was associated with an increased risk for greater reactivity in girls (odds ratio = 4.2). While preliminary, these findings suggest the importance of sex in relation to psychophysiological and temperamental reactivity, risk factors for developmental psychopathology. As our participants age, follow-up research to investigate the stability of these associations will provide valuable insights for the potential of EDA as a psychophysiological marker for developmental psychopathology risk in young children.

The Relations Between Temperament, Character, and Executive Functions in Children With ADHD and Clinical Controls

OBJECTIVE

The purpose of this study was to investigate the overlap between executive functions and temperament as measured by two questionnaires and to examine characteristic profiles in children with ADHD and clinical controls.

METHOD

Parents of 111 clinically referred children, half of whom were diagnosed with ADHD and half with other or no diagnoses, completed the Behavior Rating Inventory of Executive Function (BRIEF) and the Cloninger Junior Temperament and Character Inventory (JTCI).

RESULTS

Factor analysis of both instruments resulted in three common factors representing aspects of (1) cognitive regulation, (2) behavioral regulation, and (3) anxious/rigid tendencies. Factor (4) represented strengths and positive resources and loaded on JTCI scales only. Both instruments discriminated significantly between ADHD and non-ADHD children. Conduct disorder/oppositional defiant disorder (CD/ODD) but not ADHD accounted for problems in BRIEF Emotional Control and Self-Monitor and JTCI low Cooperativeness.

CONCLUSION

The two instruments only partially overlap and may complement each other.

What motivates individuals with ADHD? A qualitative analysis from the adolescent's point of view

Individuals with ADHD appear to respond differently to incentives than their peers. This could be due to a general altered sensitivity to reinforcers. However, apart from differences in the degree of motivation, individuals with ADHD might also be motivated by qualitatively different factors. This study aimed to harvest a range of motivational factors and identify ADHD-related qualitative differences in motivation, from the adolescent's point of view. Semi-structured interviews allowing participants to describe what motivates them in daily life were conducted with young adolescents (9-16 years) with and without ADHD. Thematic analysis was undertaken using NVivo software. Major themes relating to motivation were identified from the interview data. These were: (1) achieving a sense of togetherness; (2) feeling competent; (3) fulfilling a need for variation; (4) gaining pleasure from applying effort to achieve a goal; (5) valuing social reinforcement; (6) desiring to be absorbed/forget problems; (7) feeling free and independent, (8) attaining material reinforcement; and (9) an enjoyment of bodily stimulation. The theme structure was very similar for both groups. However, individuals with ADHD differed in some specifics: their focus on the passing of time, the absence of preference for predictable and familiar tasks, and their less elaborate description of the togetherness theme. A broad range of motivational themes was identified, stretching beyond the current focus of ADHD research and motivational theories. Similarities and differences in motivational values of individuals with and without ADHD should be taken into account in reward sensitivity research, and in psychological treatment.

The protective effect of character maturity in child aggressive antisocial behavior

BACKGROUND

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

METHODS

A sample of 1886 children with a close to equal distribution of age (9 or 12) and gender, enriched for neurodevelopmental and psychiatric problems were selected from the nationwide Child and Adolescent Twin Study in Sweden. Their parents rated them according to the Junior Temperament and Character Inventory following a telephone interview during which information about the children's development and mental health was assessed with the Autism-Tics, AD/HD and other Comorbidities inventory.

RESULT

Scores on the CD module significantly and positively correlated with scores on the Novelty Seeking temperament dimension and negatively with scores on character maturity (Self-Directedness and Cooperativeness). In the group of children with either neurodevelopmental or behavioral problems, the prevalence of low or very low character maturity was 50%, while when these two problems coexisted the prevalence of low or very low character maturity increased to 70%. Neurodevelopmental problems (such as: oppositional defiant disorder, symptoms of attention deficit/hyperactivity disorder and autism spectrum disorder) and low scores on character maturity emerged as independently significant predictors of CD; in a multivariable model, only oppositional defiant symptoms and impulsivity significantly increased the risk for coexisting CD while a mature self-agency in a child (Self-Directedness) remained a significant protective factor.

CONCLUSION

These results suggest that children's willpower, the capacity to achieve personally chosen goals may be an important protective factor - even in the presence of neurodevelopmental and psychiatric problems - against progressing into persistent negative outcomes, such as aggressive antisocial behaviors.

Risk and protective factors for mental health problems in preschool-aged children: cross-sectional results of the BELLA preschool study

BACKGROUND

Mental health problems (MHPs) in preschoolers are precursors of mental disorders which have shown to be associated with suffering, functional impairment, exposure to stigma and discrimination, as well as enhanced risk of premature death. A better understanding of factors associated with MHPs in preschoolers can facilitate early identification of children at risk and inform prevention programs. This cross-sectional study investigated the association of risk and protective factors with MHPs within a German representative community sample.

METHODS

MHPs were assessed in a sample of 391 preschoolers aged 3-6 years using the Strength and Difficulties Questionnaire (SDQ). The effects of parental MHPs, children's temperament, parental socioeconomic status (SES), social support and perceived self-competence on MHPs were assessed using bivariate and multivariate logistic regression analyses that controlled for sociodemographic characteristics.

RESULTS

Overall, 18.2% of preschoolers were classified as 'borderline or abnormal' on the total difficulties score of the SDQ. Bivariate analyses showed that parental MHPs, children's difficult temperament, and parental low SES increased the likelihood, whereas high perceived parental competence decreased the likelihood of preschool MHPs. In the multivariate analyses, only difficult child temperament remained significantly associated with preschool MHPs when other variables were controlled.

CONCLUSIONS

The results underline the importance of children's difficult temperamental characteristics as a risk factor for mental health in preschoolers and suggest that these may also be an appropriate target for prevention of preschool MHPs. More research on specific aspects of preschool children's temperament, the socioeconomic environment and longitudinal studies on the effects of these in the development of preschool MHPs is needed.

The influence of reported ADHD and substance abuse on suicidal ideation in a non-clinical sample of young men

This study intended to determine whether former and current ADHD symptomatology is associated with suicidal ideation in a non-clinical sample of 18 year old males. We performed a cross sectional descriptive study of 3280 men during the examination for military service. The investigation included a screening for substance abuse, past (WURS) and current (ADHD symptom checklist) ADHD symptomatology and an interview about suicidal ideations. We found a correlation of suicidal ideations with a history of ADHD symptomatology. ADHD symptoms were strongly consistent over time. These results indicate that a history of (diagnosed or undiagnosed) ADHD could be a predictor for suicidal ideations. Surveying a history of ADHD in primary care might help identify subjects at risk for suicidal tendencies.

The connection of temperament with ADHD occurrence and persistence into adulthood - An investigation in 18 year old males

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.

Autism spectrum disorder and attention-deficit/hyperactivity disorder in early childhood: A review of unique and shared characteristics and developmental antecedents

Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have overlapping characteristics and etiological factors, but to which extent this applies to infant- and preschool age is less well understood. Comparing the pathways to ASD and ADHD from the earliest possible stages is crucial for understanding how phenotypic overlap emerges and develops. Ultimately, these insights may guide preventative and therapeutic interventions. Here, we review the literature on the core symptoms, temperament and executive function in ASD and ADHD from infancy through preschool age, and draw several conclusions: (1) the co-occurrence of ASD and ADHD increases with age, severity of symptoms and lower IQ, (2) attention problems form a linking pin between early ASD and ADHD, but the behavioral, cognitive and sensory correlates of these attention problems partly diverge between the two conditions, (3) ASD and ADHD share high levels of negative affect, although the underlying motivational and behavioral tendencies seem to differ, and (4) ASD and ADHD share difficulties with control and shifting, but partly opposite behaviors seem to be involved.

Aggressive Antisocial Behaviors Are Related to Character Maturity in Young Swedish Violent Offenders Independent of ADHD

BACKGROUND

Antisocial personality and psychopathic traits have constantly been found to accompany criminal and aggressive behaviors, but little attention has been given to aspects of character maturity and its relation to such behaviors. The present study investigated (1) whether level of character maturity (low, medium, and high) is associated with amount of aggressive antisocial behaviors (AABs) and psychopathic traits in young men imprisoned for violent criminality, and (2) whether such an association is independent of coexisting attention-deficit hyperactivity disorder (ADHD).

METHODS

Swedish males (N = 270, aged 18-25) sentenced to prison for violent and/or sexual criminality in the western region of the Swedish Prison and Probation Service underwent a thorough clinical examination during their incarceration. Data on character maturity, as measured by the character dimensions Self-Directedness and Cooperativeness of the Temperament and Character Inventory, were available for n = 148 subjects and were used to divide these offenders into three groups with low, medium, and high character maturity. These groups were then compared for variables reflecting criminal history, a DSM-IV diagnosis of ADHD, conduct disorder (CD) and substance use disorders (SUD), aggressive behaviors, and psychopathic traits.

RESULTS

Character maturity was consistently associated with less AABs and psychopathic personality traits; the group with the highest character maturity showed: (i) a later age at onset of criminality, (ii) a smaller number of prior violent criminal acts, (iii) lower prevalence of ADHD, CD, and SUD, (iv) less self-rated and expert-rated aggressive behaviors, and (v) less psychopathic traits. The association between character maturity and aggressive behaviors/psychopathic personality traits remained even when ADHD was controlled for. The only exception was sexual criminality, where the group with the highest character maturity contained the largest amount of sexual offenders.

CONCLUSION

Higher character maturity appeared to be a protective factor among young male violent offenders, associated with less AABs, suggesting that character maturity is a promising target for treatment interventions for this group of individuals.

Changes in the Temperament and Character Inventory dimensions after paroxetine treatment in patients with major depressive disorder

Previous studies have reported changes in the dimensions of the Temperament and Character Inventory (TCI) after patients with major depressive disorder are treated. We aimed to investigate the changes in the TCI dimensions after paroxetine treatment in patients with major depressive disorder. Forty-eight patients were enrolled in this study and were treated with 10-40 mg/day of paroxetine for 6 weeks. The TCI was completed twice, at weeks 0 and 6. We used the Montgomery-Asberg Depression Rating Scale (MADRS) to evaluate patients. The participants were divided into three groups (responders, non-responders, and early responders) based on treatment response. The scores of each dimension of the TCI were compared before and after treatment using repeated-measures two-way analyses of variance. In the responders group (n = 24), no TCI dimension scores changed significantly during treatment, but the interaction between sex and MADRS score change was significantly associated with the results. In the non-responders group (n = 15), the self-directedness score increased significantly during the treatment period (p = 0.000), and the change in MADRS score significantly affected the results. In the early responders group (n = 9), no TCI dimension scores changed significantly during treatment. The results of the present study may reveal a possible correlation between paroxetine treatment and changes in personality traits.